Individual provider · Type 1 NPI

Dominick Detommaso, D.P.M.

Foot & Ankle Surgery Podiatrist · Fort Wayne, IN

NPI number 1013910041 Active

Practice location

7601 W Jefferson Blvd
Fort Wayne, IN 46804-4133

Fax (260) 436-8585

Specialties and licenses

TaxonomyCodeLicense
Foot & Ankle Surgery Podiatrist Primary 213ES0103X07000410A (IN)
Podiatrist 213E00000X07000410A (IN)

Foot & Ankle Surgery Podiatrist: Definition to come...

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About NPI 1013910041

Dominick Detommaso, D.P.M.'s National Provider Identifier is 1013910041, issued on May 23, 2005. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Fort Wayne, IN. The record was last updated on Mar 22, 2016.