Organization
ASSOCIATED SURGEONS AND PHYSICIANS, LLC
Active
Other names
Dupont Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
TRISH WARREN (CFO)
(260) 432-4400
Entity
Organization
Contact information
Practice address
2510 E DUPONT RD, SUITE 200, FORT WAYNE, IN 46825-1601
(260) 432-4913
(260) 969-6832
Mailing address
2518 E DUPONT RD, FORT WAYNE, IN 46825-1675
(260) 432-4400
(260) 969-6884
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01065437A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201338430Q
—
IN
Enumeration date
07/20/2015
Last updated
07/18/2016
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