Provider Demographics
NPI:1255417515
Name:WUBBENHORST, MONIQUE CHIREAU (MD)
Entity type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:CHIREAU
Last Name:WUBBENHORST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:MONIQUE
Other - Middle Name:VERA
Other - Last Name:CHIREAU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:11109 PARKVIEW PLAZA DR # 117
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46845-1701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1355 MARINERS DR
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:IN
Practice Address - Zip Code:46582-7145
Practice Address - Country:US
Practice Address - Phone:574-372-1282
Practice Address - Fax:571-372-1275
Is Sole Proprietor?:No
Enumeration Date:2006-10-30
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200000375207V00000X
IN01088465A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology