Individual
HOUSHMAND REZVANI
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
909 E STATE BLVD, FORT WAYNE, IN 46805-3404
(260) 481-2700
(260) 481-2717
Mailing address
909 E STATE BLVD, FORT WAYNE, IN 46805-3404
(260) 481-2700
(260) 481-2717
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01044895A
IN
Other
Enumeration date
02/22/2006
Last updated
07/08/2007
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