Individual
ERIC TODD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 426-5431
(260) 460-1385
Mailing address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 426-5431
(260) 460-1385
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
35.122870
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0098948
—
OH
05
—
4108684
—
MI
01
—
FT069788
LICENSE
MI
Enumeration date
10/11/2006
Last updated
09/27/2023
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