IndividualActive
Blandine Bustamante, M.D.
NPI 1093799546 · Anatomic Pathology & Clinical Pathology Physician · Ft Wayne, IN
Provider details
- NPI number
- 1093799546
- Entity type
- Individual
- Primary specialty
- Anatomic Pathology & Clinical Pathology PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- License
- 01042290A (IN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
2200 Randallia Dr
Ft Wayne, IN 46805-4638
Phone: (260) 424-2195
Approximate (ZIP-level) locationGet directions
Mailing address
2458 Lake Ave
Fort Wayne, IN 46805-5406
Registry dates
- Enumerated
- 2005-11-29
- Last updated
- 2010-04-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.