Individual
DOMINICK JOSEPH ACQUARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
7806 W JEFFERSON BLVD STE E, FORT WAYNE, IN 46804-4180
(260) 459-0087
(260) 969-8514
Mailing address
7806 W JEFFERSON BLVD STE E, FORT WAYNE, IN 46804-4180
(260) 459-0087
(260) 969-8514
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02006542A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
STATE LICENSE
IN
Enumeration date
05/01/2018
Last updated
10/13/2024
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