Basic Information
Provider Information
NPI: 1952406910
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FECHER
FirstName: ALISON
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6920 POINTE INVERNESS WAY STE 200
Address2:  
City: FORT WAYNE
State: IN
PostalCode: 468047934
CountryCode: US
TelephoneNumber: 2604793514
FaxNumber: 2604793520
Practice Location
Address1: 7900 W JEFFERSON BLVD STE 306
Address2:  
City: FORT WAYNE
State: IN
PostalCode: 468044128
CountryCode: US
TelephoneNumber: 2604583610
FaxNumber: 2604583611
Other Information
ProviderEnumerationDate: 09/14/2006
LastUpdateDate: 09/23/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/23/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0200XMD427231PAN Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
2086S0127X01065558AINY Allopathic & Osteopathic PhysiciansSurgeryTrauma Surgery

ID Information
IDTypeStateIssuerDescription
20094154005IN MEDICAID
26069014701INMEDICARE PINOTHER


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