Organization
SUMMIT MEDICAL ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BHAKTAVATSALA R APURI M.D. (OWNER)
(260) 434-1177
Entity
Organization
Contact information
Practice address
4656 W JEFFERSON BLVD, SUITE 125, FORT WAYNE, IN 46804-6857
(260) 434-1177
(888) 854-6745
Mailing address
4656 W JEFFERSON BLVD, SUITE 125, FORT WAYNE, IN 46804-6857
(260) 434-1177
(888) 854-6745
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200468080A
—
IN
Enumeration date
09/14/2006
Last updated
12/29/2020
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