Individual
EKATERINA DIANOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11115 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845-1701
(260) 672-6443
(260) 672-6459
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
01089191A
IN
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Enumeration date
04/04/2017
Last updated
09/05/2023
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