# FORT WAYNE CARDIOVASCULAR SURGEONS, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679551741
- **Authorized official:** DOUGLAS L GRAY MD (PRESIDENT)
- **Authorized official phone:** (260) 483-6448

## Contact information

- **Practice address:** 1818 CAREW ST, SUITE 250, FORT WAYNE, IN 46805-4788
- **Practice address phone:** (260) 483-6448
- **Practice address fax:** (260) 373-4167
- **Mailing address:** 1818 CAREW ST, SUITE 250, FORT WAYNE, IN 46805-4788
- **Mailing address phone:** (260) 483-6448
- **Mailing address fax:** (260) 373-4167

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/09/2006
- **Last updated:** 10/22/2007