Provider Demographics
NPI:1033523808
Name:AUBREY, CLAIRE (DO)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:
Last Name:AUBREY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6920 POINTE INVERNESS WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-7934
Mailing Address - Country:US
Mailing Address - Phone:260-458-3045
Mailing Address - Fax:260-479-2947
Practice Address - Street 1:2512 E DUPONT RD STE 110
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-1609
Practice Address - Country:US
Practice Address - Phone:260-458-3045
Practice Address - Fax:260-479-2947
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-19
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN02007527A208800000X
IN0200XXX208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300083329Medicaid