# NORTHEAST OBSTETRICS & GYNECOLOGY, LLC

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

## Provider details

- **NPI number:** 1831354471
- **Authorized official:** TAMI A FURNISS (BUSINESS MANAGER)
- **Authorized official phone:** (260) 426-7755

## Contact information

- **Practice address:** 2414 E STATE BLVD, SUITE 101, FORT WAYNE, IN 46805-4760
- **Practice address phone:** (260) 422-7455
- **Practice address fax:** (260) 422-0086
- **Mailing address:** 2414 E STATE BLVD, SUITE 101, FORT WAYNE, IN 46805-4760
- **Mailing address phone:** (260) 422-7455
- **Mailing address fax:** (260) 422-0086

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/23/2008
- **Last updated:** 07/23/2008