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Contact Information

FORT WAYNE CARDIOLOGY CORPORATION
11558 SR 111
PAULDING, OH45879
 Phone: 260-481-4700
 Fax: 260-481-4808
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
 

Clinical Cardiac Electrophysiology

207RC0001X 11 Physician/Internal Medicine
 

Interventional Cardiology

207RI0011X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for FORT WAYNE CARDIOLOGY CORPORATION

NPI Number 1669458733
LBN Legal business name FORT WAYNE CARDIOLOGY CORPORATION
Authorized official RAYMOND DUSMAN - (CEO)
Entity Organization
Organization subpart 1 Yes
Enumeration date 12/20/2005
Last updated 10/07/2008 - About 18 years ago
Identifiers
IN Medicaid 200425420M
OH Other CK8615 RR MEDICARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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