Organization
MGFW SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOEL R SAUER (CEO)
(260) 432-2297
Entity
Organization
Contact information
Practice address
7916 W. JEFFERSON BLVD., STE 100, FORT WAYNE, IN 46804
(260) 432-2297
(260) 434-6420
Mailing address
PO BOX 2594, FORT WAYNE, IN 46801-2594
(260) 432-2297
(260) 434-6420
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000372266
ANTHEM
IN
01
—
68579
AAAHC
IN
01
—
P00220062
MEDICARE - RAILROAD
IN
Enumeration date
07/09/2006
Last updated
03/24/2008
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