Organization · Type 2 NPI
Great Lakes Pediatric Surgeons, Inc.
Pediatric Surgery Physician · Fort Wayne, IN
NPI number
1669455267
Active
Practice location
7613 W Jefferson Blvd Ste 200
Fort Wayne, IN 46804-4182
Fax (260) 469-7340
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Surgery Physician Primary | 2086S0120X | None listed |
Pediatric Surgery Physician: A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.
5 other providers at this address
- Carey Lane Watson, MDPediatric Surgery Physician Fort Wayne, IN NPI 1679891097
- David Allen Smith, MDPediatric Surgery Physician Fort Wayne, IN NPI 1962405993
- Elizabeth Ann Meyer, PA-CPhysician Assistant Fort Wayne, IN NPI 1902561020
- Jo A. Cooke-Barber, MDPediatric Surgery Physician Fort Wayne, IN NPI 1417215922
- Josiah Wesley Reish, CPNP-ACPediatric Nurse Practitioner Fort Wayne, IN NPI 1265047138
About NPI 1669455267
Great Lakes Pediatric Surgeons, Inc.'s National Provider Identifier is 1669455267, issued on Nov 29, 2005. The primary taxonomy on file is Pediatric Surgery Physician (2086S0120X), and the practice location is in Fort Wayne, IN. The record was last updated on Mar 14, 2008.