THREE RIVERS DERMATOLOGY, LLC is a specialist in Fort Wayne, IN. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. THREE RIVERS DERMATOLOGY, LLC NPI is 1992991475. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Three Rivers Dermatology.
The provider's business location address is:
5650 COVENTRY LN
FORT WAYNE, IN
ZIP 46804-140
Phone: (260) 436-9696
Fax: (260) 436-9424
The provider's authorized official is Jeffrey Walter Sassmannshausen .
The authorized official title is Ceo/owner and has the following contact phone number (260) 436-9696.
The CLIA number assigned to this NPI record is 15D1001693 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).
The enumeration date for this NPI number is 9/19/2007 and was last updated on 6/12/2020.