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Organization

PLASTIC SURGERY INNOVATIONS, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOSEPH M. MLAKAR M.D. (PRESIDENT/OWNER/PHYSICIAN)
(260) 490-4673
Entity
Organization

Contact information

Practice address
9933 DUPONT CIRCLE DR W STE 120, FORT WAYNE, IN 46825-1629
(260) 490-4673
(260) 490-2165
Mailing address
9933 DUPONT CIRCLE DR W STE 120, FORT WAYNE, IN 46825-1629
(260) 490-4673
(260) 490-2165

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2723806
OH
Enumeration date
09/28/2006
Last updated
01/04/2022
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