Individual
MRS. CARRY E DEPOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
2200 RANDALLIA DR, PROFESSIONAL EMERGENCY PHYSICIANS, FORT WAYNE, IN 46805-4638
(260) 373-4000
(260) 482-4442
Mailing address
3640 NEW VISION DR, PROFESSIONAL EMERGENCY PHYSICIANS, SUITE A, FORT WAYNE, IN 46845-1717
(260) 482-4440
(260) 482-4442
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001452A.
IN
Other
Enumeration date
12/23/2005
Last updated
06/04/2013
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