Individual
DR. MARVIN EUGENE EASTLUND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5204 TATUM CT, FORT WAYNE, IN 46835-4633
(260) 486-9432
Mailing address
5204 TATUM CT, FORT WAYNE, IN 46835-4633
(260) 486-9432
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
01022999A
IN
Other
Enumeration date
03/05/2007
Last updated
07/08/2007
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