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Organization
FORT WAYNE CARDIOVASCULAR SURGEONS, PC
Active
Organization
FORT WAYNE CARDIOVASCULAR SURGEONS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS L GRAY MD (PRESIDENT)
(260) 483-6448
Entity
Organization
Contact information
Practice address
1818 CAREW ST, SUITE 250, FORT WAYNE, IN 46805-4788
(260) 483-6448
(260) 373-4167
Mailing address
1818 CAREW ST, SUITE 250, FORT WAYNE, IN 46805-4788
(260) 483-6448
(260) 373-4167
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
NULL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Enumeration date
01/09/2006
Last updated
10/22/2007
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