Organization
PEDIATRICS CENTER OF FORT WAYNE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH FEDORIW B.A., M.A. (OFFICE ADMINISTRATOR)
(260) 422-4096
Entity
Organization
Contact information
Practice address
3030 LAKE AVE, #25A, FORT WAYNE, IN 46805-5428
(260) 422-4096
(260) 424-2551
Mailing address
3030 LAKE AVE, #25A, FORT WAYNE, IN 46805-5428
(260) 422-4096
(260) 424-2551
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
10137509
IN
Other
Enumeration date
03/14/2007
Last updated
08/22/2020
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