Individual
THOMAS E SAROSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3707 NEW VISION DR, FORT WAYNE, IN 46845
(260) 471-9466
Mailing address
3707 NEW VISION DR, FORT WAYNE, IN 46845-1702
(260) 471-9466
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01037097
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000092614
ANTHEM
IN
05
—
100323300
—
IN
01
—
1806
PHP
IN
05
—
2100578
—
OH
05
—
4074951100
—
MI
Enumeration date
05/23/2006
Last updated
07/10/2018
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