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Individual

PATRICK B. ILADA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1000 PROVIDENT DR STE C, WARSAW, IN 46580-3255
(574) 267-8728
(574) 269-3470
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 479-3513
(260) 479-3520

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01054010A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200326000
IN
Enumeration date
06/01/2006
Last updated
10/01/2020
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