Fort Wayne Cardiovascular Surgeon

NPI 1790718765 - Thoracic Surgery (Cardiothoracic Vascular Surgery) - 208G00000X

NPI Details
NPI 1790718765
Enumeration Date 07/10/2006
Last Updated 07/09/2007
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name DOUGLAS L DOUGLAS
Position PRESIDENT/PARTNER
Phone (260) 483-6448
Fax (260) 373-4167
Practice Location
11123 PARKVIEW PLAZA DR
SUITE 202
FORT WAYNE IN, 46845-1707, US
Phone (260) 483-6448
Fax (260) 373-4167
Business Location
1818 CAREW STREEET
SUITE 250
FORT WAYNE IN, 46805, US
Phone (260) 483-6448
Fax (260) 373-4167
Toxanomy
Taxonomy Code 208G00000X
License State Indiana
License Number 50000046A
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According to our database, Fort Wayne Cardiovascular Surgeon NPI is 1790718765, taxonomy code is 208G00000X and license number is 50000046A, license state is located at Indiana. Fort Wayne Cardiovascular Surgeon physically located at 11123 Parkview Plaza Dr, Fort Wayne IN, 46845-1707. NPI Number 1033115704 has the healthcare provider type.

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1790718765 NPI number is provided on an as is basis without warranty of any kind. 1790718765 is maintained by the National Plan & Provider Enumeration System. The contents of Fort Wayne Cardiovascular Surgeon are for informational purposes only.