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Contact Information

NORTHEAST INDIANA PEDIATRIC SPECIALISTS, PC
11123 PARKVIEW PLAZA DR
STE # 102
FORT WAYNE, IN46845-1707
 Phone: 260-483-0688
 Fax: 260-483-0798
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Infectious Diseases

2080P0208X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for NORTHEAST INDIANA PEDIATRIC SPECIALISTS PC · (Female)

NPI # 1629267323
Status Active
Credentials
Entity Individual
Enumeration date 10/18/2007
Last updated 10/18/2007 - About 19 years ago
Sole proprietor 1 Not specified
Identifiers
  • IN License # 50004150A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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