Organization
GYNECOLOGIC ONCOLOGY OF NORTHEAST INDIANA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IWONA PODZIELINSKI MD (PRESIDENT/OWNER)
(260) 437-4789
Entity
Organization
Contact information
Practice address
1818 CAREW ST, SUITE 250, FORT WAYNE, IN 46805-4788
(260) 437-4789
Mailing address
PO BOX 307, ROANOKE, IN 46783-0307
(260) 437-4789
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0107737
—
OH
05
—
201236690
—
IN
Enumeration date
07/09/2014
Last updated
06/21/2016
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