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Individual

FAUSTO G. DEVECCHI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
7916 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 432-2297
(260) 434-6433
Mailing address
6920 POINTE INVERNESS WAY STE 200, MEDPARTNERS, ATTN: BARB COPELAND, FORT WAYNE, IN 46804-7934
(260) 479-3514
(260) 479-3520

Taxonomy

Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
01066231A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000615407
ANTHEM
IN
05
200943230
IN
01
P00783755
RAILROAD MEDICARE
IN
Enumeration date
05/04/2007
Last updated
12/19/2016
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