NPI 1013163526

Benjamin Jon Moreno, MDPHD

Practitioner Diagnostic Radiology Physician Fort Wayne, IN

Practice location

Address: 3707 New Vision Dr STE 110, Fort Wayne, IN 46845-1702
Phone: (260) 469-6602
Fax: (260) 484-5919
Mailing address: 3707 New Vision Dr, Fort Wayne, IN 46845-1702

Registered specialties (2)

Diagnostic Radiology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2085R0202X Licence 01070072 (IN)

Other Radiology providers in Indiana →

Vascular & Interventional Radiology Physician

Allopathic & Osteopathic Physicians Taxonomy 2085R0204X Licence 01070072 (IN)

Registry record

NPI: 1013163526
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Aug 2008
Record last updated: 5 Mar 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.