# ACQUARO MEDICAL PRACTICE, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** DOMINICK JOSEPH ACQUARO
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063276590
- **Authorized official:** DOMINICK JOSEPH ACQUARO DO (LEAD CO-OWNER)
- **Authorized official phone:** (260) 459-0087

## Contact information

- **Practice address:** 7806 W JEFFERSON BLVD STE E, FORT WAYNE, IN 46804-4180
- **Practice address phone:** (260) 459-0087
- **Practice address fax:** (260) 969-8514
- **Mailing address:** 7806 W JEFFERSON BLVD STE E, FORT WAYNE, IN 46804-4180
- **Mailing address phone:** (260) 459-0087
- **Mailing address fax:** (260) 969-8514

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/06/2024
- **Last updated:** 02/06/2024