Organization
NOVA PHYSICIAN GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRENCE MORTON JR. (SR. MEDICAL DIRECTOR)
(773) 733-9730
Entity
Organization
Contact information
Practice address
436 E WASHINGTON BLVD, FORT WAYNE, IN 46802-3210
(260) 298-6240
(206) 474-3157
Mailing address
30 W MONROE ST STE 1200, CHICAGO, IL 60603-2420
(773) 352-1515
(312) 929-0373
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
05/01/2024
Last updated
05/01/2024
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