# PAOLO C GIACOMINI, M.D. PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ash Street Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790940476
- **Authorized official:** PAOLO C. GIACOMINI C GIACOMINI M.D. (OWNER)
- **Authorized official phone:** (260) 563-8875

## Contact information

- **Practice address:** 400 ASH ST, WABASH, IN 46992-1954
- **Practice address phone:** (260) 563-8875
- **Practice address fax:** (260) 569-9803
- **Mailing address:** 400 ASH ST, WABASH, IN 46992-1954
- **Mailing address phone:** (260) 563-8875

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 01038356 | IN | Yes |

## Other

- **Enumeration date:** 07/22/2008
- **Last updated:** 07/22/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200042050A | — | IN |