Provider Demographics
NPI:1245285600
Name:POSWINSKI, COURTNEY E (MD)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:E
Last Name:POSWINSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3640 NEW VISION DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46845-1717
Mailing Address - Country:US
Mailing Address - Phone:260-482-4440
Mailing Address - Fax:260-482-4442
Practice Address - Street 1:3640 NEW VISION DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46845-1717
Practice Address - Country:US
Practice Address - Phone:260-482-4440
Practice Address - Fax:260-482-4442
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01059416A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200813910Medicaid
IN047840036OtherMEDICARE PTAN
I51461Medicare UPIN
IN178650BBBMedicare ID - Type Unspecified