Provider Demographics
NPI:1003254236
Name:ABER, DANYELLE R (MD)
Entity Type:Individual
Prefix:DR
First Name:DANYELLE
Middle Name:R
Last Name:ABER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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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 1:1316 EAST SEVENTH STREET
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:IN
Practice Address - Zip Code:46706-2515
Practice Address - Country:US
Practice Address - Phone:260-925-4600
Practice Address - Fax:260-482-4442
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01076367A207Q00000X, 207P00000X
IN11016991A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000996490OtherANTHEM
IN201180120Medicaid