Individual
MARK STEVEN GAWEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6652 SAINT JOE RD, FORT WAYNE, IN 46835-1974
(260) 485-7007
(260) 486-7887
Mailing address
6652 SAINT JOE RD, FORT WAYNE, IN 46835-1974
(260) 485-7007
(260) 486-7887
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
8824
IN
171WH0202X
Home Modifications Contractor
200802140
IN
171WV0202X
Vehicle Modifications Contractor
200806100
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20-3345786
TAX ID
IN
05
—
200802140 A
—
IN
05
—
200806100 A
—
IN
01
—
610371770
DUN & BRADSTREET
IN
Enumeration date
08/31/2006
Last updated
01/27/2014
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