Provider Demographics
NPI:1518958909
Name:GIANT, DONALD J (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:J
Last Name:GIANT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6920 POINTE INVERNESS WAY STE 200
Mailing Address - Street 2:MEDPARTNERS, ATTN: MEGAN FORTNEY
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-7934
Mailing Address - Country:US
Mailing Address - Phone:260-479-3515
Mailing Address - Fax:260-479-3520
Practice Address - Street 1:504 W SOUTH ST
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:IN
Practice Address - Zip Code:46773-9592
Practice Address - Country:US
Practice Address - Phone:260-623-6196
Practice Address - Fax:260-623-6619
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01036258A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100318030Medicaid
OH2489874Medicaid
000000091875OtherBLUE CROSS BLUE SHIELD
IN100318030Medicaid
INM400048115Medicare PIN
INM400048115Medicare PIN
D94414Medicare UPIN
IN925500LMedicare PIN
1325OtherPHYSICIANS HEALTH PLAN
OH2489874Medicaid
000000091875OtherBLUE CROSS BLUE SHIELD