NPI: 1811941024
Provider Name: NORTHEAST OBSTETRICS & GYNECOLOGY, LLC
Doing Business As: NORTHEAST OB-GYN, LLC
Classification: Clinic/Center - 261QM2500X
Entity Type: Organization
Specialization: Medical Specialty
Address:
11123 PARKVIEW PLAZA DR
SUITE 101
FORT WAYNE, IN
ZIP 46845
Phone: (260) 422-7455
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NORTHEAST OBSTETRICS & GYNECOLOGY, LLC is a medical specialty clinic center in Fort Wayne, IN. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). NORTHEAST OBSTETRICS & GYNECOLOGY, LLC NPI is 1811941024. The provider is registered as an organization entity type.
The provider Is Doing Business As Northeast Ob-gyn, Llc.
The provider's business location address is:
11123 PARKVIEW PLAZA DR
SUITE 101
FORT WAYNE, IN
ZIP 46845-707
Phone: (260) 422-7455
Fax: (260) 424-9356
The provider's authorized official is Tamara A Furniss .
The authorized official title is Business Manager and has the following contact phone number (260) 426-7755.
The enumeration date for this NPI number is 5/20/2006 and was last updated on 6/24/2008.