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Contact Information

MOHAMED G GENDY, MD
7802 W JEFFERSON BLVD STE A
FORT WAYNE, IN46804-4138
 Phone: 260-305-2822
 Fax: 260-305-2829
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for MOHAMED G GENDY · (Male)

NPI Number 1508183427
Status Active
Credentials MD
Entity Individual
Enumeration date 05/02/2010
Last updated 12/01/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 036137626
  • IN License # 01088661A
  • WI License # 60540
  • IN Medicaid 300067629
  • WI Medicaid 1508183427
  • IN Other IN5423002 MEDICARE
Hospital affiliation(s)
  • ST JOHNS HOSPITAL - (Acute Care)
    800 E CARPENTER ST
    SPRINGFIELD, IL 62769
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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