Individual
DR. ABHILASH PERISETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
11050 PARKVIEW CIRCLE DR, FORT WAYNE, IN 46845-1739
(833) 724-8326
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Q7451
TX
207RG0100X
Gastroenterology Physician
Primary
01084909A
IN
208M00000X
Hospitalist Physician
35.123049
OH
390200000X
Student in an Organized Health Care Education/Training Program
RL11813
ND
Other
Enumeration date
07/20/2011
Last updated
06/01/2021
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