Individual
DR. SMITHA PATIBANDLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
800 BROADWAY, SUITE 315, FORT WAYNE, IN 46802-2149
(260) 489-6030
(260) 489-5536
Mailing address
800 BROADWAY, SUITE 315, FORT WAYNE, IN 46802-2149
(260) 489-6030
(260) 489-5536
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01066011A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200969710
—
IN
Enumeration date
06/06/2008
Last updated
08/24/2016
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