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Organization

BLUE CRESCENT BLUE STAR MEDICAL OF INDIANA, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SUNDIATA M EL-AMIN M.D. (OWNER)
(859) 823-0000
Entity
Organization

Contact information

Practice address
2326 HOBSON RD, FORT WAYNE, IN 46805-2916
(859) 823-0000
Mailing address
2326 HOBSON RD, FORT WAYNE, IN 46805-2916
(859) 823-0000

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Enumeration date
03/17/2011
Last updated
03/17/2011
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