Organization
FORT WAYNE PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VISHAAL VEERULA MD (OWNER)
(260) 999-6924
Entity
Organization
Contact information
Practice address
7802 W JEFFERSON BLVD STE A, FORT WAYNE, IN 46804-4138
(260) 999-6924
(260) 222-2844
Mailing address
7802 W JEFFERSON BLVD STE A, FORT WAYNE, IN 46804-4138
(260) 999-6924
(260) 222-2844
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
05/27/2022
Last updated
05/27/2022
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