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Organization
FORT WAYNE GI PATHOLOGY SERVICES, PC, INC.
Active
Organization
FORT WAYNE GI PATHOLOGY SERVICES, PC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MAX L DANIELS (CORPORATE MANAGER)
(260) 432-5867
Entity
Organization
Contact information
Practice address
7950 W JEFFERSON BLVD, GI PATHOLOGY, FORT WAYNE, IN 46804-4140
(260) 435-7154
(260) 435-7633
Mailing address
6110 CONSTITUTION DR, SUITE 112, FORT WAYNE, IN 46804-1556
(260) 432-5867
(260) 436-9013
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
50004501A
IN
Other
Enumeration date
02/20/2007
Last updated
08/22/2020
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