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Organization
INDIANA PLASTIC SURGERY CENTER, PC
Active
Organization
INDIANA PLASTIC SURGERY CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT N SEVERINAC M.D. (PRESIDENT)
(260) 489-0099
Entity
Organization
Contact information
Practice address
10020 DUPONT CIRCLE CT, SUITE 100, FORT WAYNE, IN 46825-1620
(260) 489-0099
(260) 489-0066
Mailing address
10020 DUPONT CIRCLE CT, SUITE 100, FORT WAYNE, IN 46825-1620
(260) 489-0099
(260) 489-0066
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
01043388A
IN
Other
Enumeration date
01/22/2013
Last updated
01/22/2013
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