Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
PRATYUSHA TANTRAVAHI, D.O.
Active Sole ProprietorPRATYUSHA TANTRAVAHI, D.O. is a Family Medicine healthcare provider located in FORT WAYNE, Indiana. NPI 1295198414 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · FORT WAYNE, IN
Registration Details
- NPI Number
- 1295198414
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Apr 4, 2016 (10.358605426575 yrs)
- Last Updated
- Oct 14, 2022
- Licenses
-
02006015 (IN)02006015A (IN)15769 (ND)
- Sole Proprietor
- Yes
Practice Information
- Address
-
11109 PARKVIEW PLAZA DRFORT WAYNE, IN, 468451701Browse IN providers · Browse ZIP 46845
- Phone
- 2602662020
- Fax
- 2602662009
- Primary Specialty
-
Family Medicine
207Q00000X
- Additional Specialty
- Family Medicine
- Additional Specialty
- Family Medicine
- Additional Specialty
- Student (Health Education/Training)
Other Family Medicine Providers in FORT WAYNE, IN
| Name | Credential | NPI |
|---|---|---|
| DR. JOSEPH ROBERT HUGUENARD | MD | 1598767782 |
| TODD ROBERT PAGE | MD | 1184622367 |
| LYNN VAN VALER FAUR | MD | 1326047721 |
| DENISE M SMITH | DO | 1912907445 |
| WILLIAM D GOUDY | D.O. | 1568462935 |
| ,BIRUTE L PUMPUTIS | MD | 1326048455 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.