Individual
ROBERT NICHOLAS SEVERINAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10020 DUPONT CIRCLE CT, SUITE 100, FORT WAYNE, IN 46825-1620
(260) 489-0099
(260) 489-0066
Mailing address
10020 DUPONT CIRCLE CT, SUITE 100, FORT WAYNE, IN 46825-1620
(260) 489-0099
(260) 489-0066
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
01043388A
IN
Other
Enumeration date
08/09/2006
Last updated
07/08/2007
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