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BLANDINE B BUSTAMANTE M.D.
NPI 1093799546
Pathology - Anatomic Pathology & Clinical Pathology in Ft Wayne, IN

Active since November 29, 2005
2200 RANDALLIA DR, FT WAYNE, IN 46805(260) 424-2195 Get Directions Write a Review

NPPES record last updated: April 29, 2010. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Blandine B Bustamante M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLANDINE B BUSTAMANTE M.D. (NPI 1093799546) is an individual anatomic pathology & clinical pathology provider in Ft Wayne, Indiana, licensed in Indiana (01042290A) and active in the NPI registry since November 2005.

NPPES Registry Identity

NPI1093799546
Entity TypeIndividualFemale
Primary Taxonomy207ZP0102X
Provider Legal NameBLANDINE B BUSTAMANTECredential: M.D.
Location Address2200 RANDALLIA DRFt Wayne, IN 46805-4638
Mailing Address2458 Lake AveFort Wayne, IN 46805-5406 · (260) 424-2195
Phone(260) 424-2195
Sole ProprietorNo
Enumeration DateNovember 29, 2005
Last NPPES UpdateApril 29, 2010
✔ NPI 1093799546 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPathology · Anatomic Pathology & Clinical PathologyAllopathic & Osteopathic Physicians
Taxonomy Code207ZP0102X
License✔ Licensed in IN · 01042290A
Definition

A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.

2200 RANDALLIA DR, Ft Wayne, IN 46805
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Other Identifiers 3

Medicaid200002580IN
Medicare OSCAR/certification132780IIN
Medicare UPINF03039IN

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MALLIKA GYAWALI MD
Internal Medicine
2200 RANDALLIA DR
FORT WAYNE, IN 46805
Allen County (260) 373-4000
CHRISTINA MCGUIRK
Emergency Medicine
2200 RANDALLIA DR
FORT WAYNE, IN 46805
Allen County (260) 373-4000
MS. KARI M RASMUSSEN PA-C
Physician Assistant (Medical)
2200 RANDALLIA DR
FORT WAYNE, IN 46805
Allen County (260) 373-4000
MR. THOMAS G EDWARDS PA-C
Physician Assistant (Medical)
2200 RANDALLIA DR
FORT WAYNE, IN 46805
Allen County (260) 373-4000
ST. VINCENT HOSPITAL AND HEALTH CARE CENTER, INC.
Pediatrics (Neonatal-Perinatal Medicine)
2200 RANDALLIA DR
FORT WAYNE, IN 46805
Allen County (800) 727-8439
JACQUOLYNN LEE PLOUGHE BSN, RN, CRRN
Registered Nurse
2200 RANDALLIA DR
FORT WAYNE, IN 46805
Allen County (260) 266-4172
DAVID R WANG DO, MPH
Student in an Organized Health Care Education/Training Program
2200 RANDALLIA DR
FORT WAYNE, IN 46805
Allen County (260) 373-7765
CHELSIE MCSORLEY NP
Nurse Practitioner
2200 RANDALLIA DR
FORT WAYNE, IN 46805
Allen County (260) 373-0670

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Blandine Bustamante's NPI number?

The NPI number for Blandine Bustamante is 1093799546. It was assigned to this individual provider in the NPPES registry on November 29, 2005.

Where is Blandine Bustamante located?

Blandine Bustamante practices at 2200 Randallia Dr, Ft Wayne, IN 46805. The listed phone number is (260) 424-2195.

What is Blandine Bustamante's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Anatomic Pathology & Clinical Pathology, with taxonomy code 207ZP0102X.

When was this NPI record last updated?

The NPPES record for Blandine Bustamante was last updated on April 29, 2010. NPI Profile syncs with the weekly NPPES data releases published by CMS.