Organization
THREE RIVERS MEDICAL ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BINOY OUSEPH MD (OFFICE MANAGER)
(260) 402-7446
Entity
Organization
Contact information
Practice address
7910 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4159
(260) 402-7446
(260) 435-7007
Mailing address
2331 LADUE LANE, FORT WAYNE, IN 46804
(260) 402-7446
(260) 435-7007
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
01052976A
IN
Other
Enumeration date
09/21/2006
Last updated
10/24/2007
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