Organization
PSYCHIATRIC SERVICES P C
Active
Organization
PSYCHIATRIC SERVICES P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAHENDER REDDY SURAKANTI M.D (M.D.)
(260) 425-3204
Entity
Organization
Contact information
Practice address
800 BROADWAY, STE 208, FORT WAYNE, IN 46802-2149
(260) 425-3204
(260) 425-3206
Mailing address
PO BOX 40139, FORT WAYNE, IN 46804-0139
(260) 425-3204
(260) 425-3206
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01057700A
IN
Other
Enumeration date
10/15/2007
Last updated
02/05/2010
Update your record
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