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FORT WAYNE CARDIOVASCULAR SURGEONS PC NPI 1679551741


NPI Information

NPI: 1679551741
Provider Name: FORT WAYNE CARDIOVASCULAR SURGEONS, PC
Classification: Thoracic Surgery (Cardiothoracic Vascular Surgery) - 208G00000X
Entity Type: Organization
Address:
1818 CAREW ST
SUITE 250
FORT WAYNE, IN
ZIP 46805
Phone: (260) 483-6448
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FORT WAYNE CARDIOVASCULAR SURGEONS, PC is a thoracic surgery cardiothoracic vascular surgery in Fort Wayne, IN. The provider is a thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. FORT WAYNE CARDIOVASCULAR SURGEONS, PC NPI is 1679551741. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1818 CAREW ST
SUITE 250
FORT WAYNE, IN
ZIP 46805-788
Phone: (260) 483-6448
Fax: (260) 373-4167

The provider's authorized official is Douglas L Gray .
The authorized official title is President and has the following contact phone number (260) 483-6448.

The enumeration date for this NPI number is 1/9/2006 and was last updated on 10/22/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1C15472OTHERINDIANATRAVELERS MEDICARE
2046240MEDICARE ID-TYPE UNSPECIFIEDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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