Organization
MELMAR LLC
Active
Other names
Indiana Vein and Laser Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARCUS A JIMENEZ M.D. (COO)
(260) 432-7654
Entity
Organization
Contact information
Practice address
2410 N GLENDALE DR, SUITE C, FORT WAYNE, IN 46804-8908
(260) 432-7654
(260) 432-7709
Mailing address
2410 N GLENDALE DR, SUITE C, FORT WAYNE, IN 46804-8908
(260) 432-7654
(260) 432-7709
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
01043881A
IN
Other
Enumeration date
06/07/2007
Last updated
08/22/2020
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