Organization
SUMMIT RETINA CONSULTANTS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VELIMIR PETROVIC MD (PRESIDENT)
(260) 515-2778
Entity
Organization
Contact information
Practice address
6435 W JEFFERSON BLVD # 203, FORT WAYNE, IN 46804-6203
(260) 515-2778
Mailing address
6435 W JEFFERSON BLVD # 203, FORT WAYNE, IN 46804-6203
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
50005075A
IN
Other
Enumeration date
01/21/2010
Last updated
01/21/2010
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