Individual
SHAOXUAN GUO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11109 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845-1701
(260) 672-6620
(260) 672-6639
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10004699A
IN
Other
Enumeration date
11/08/2024
Last updated
03/03/2025
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