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Organization
DUPONT OB-GYN
Active
Organization
DUPONT OB-GYN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSEMARY LEITCH MD FACOG (OWNER)
(260) 490-6260
Entity
Organization
Contact information
Practice address
11123 PARKVIEW PLAZA DR, SUITE 204, FT WAYNE, IN 46845
(260) 490-6260
(260) 490-6261
Mailing address
11123 PARKVIEW PLAZA DR, SUITE 204, FT WAYNE, IN 46845
(260) 490-6260
(260) 490-6261
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01035629
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000093382
ANTHEM BCBS
IN
Enumeration date
07/31/2006
Last updated
12/11/2007
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