Organization
INDIANA WOUND CARE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAIL RYAN (OFFICE MANAGER)
(260) 424-9000
Entity
Organization
Contact information
Practice address
700 BROADWAY FL 2, FORT WAYNE, IN 46802-1402
(260) 424-9000
(260) 425-3029
Mailing address
PO BOX 10493, FORT WAYNE, IN 46852-0493
(260) 424-9000
(260) 425-3029
Taxonomy
Speciality
Code
Description
License number
State
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
50004525A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200437440A
—
IN
01
—
DA1057
MEDICARE RAILROAD
IN
Enumeration date
11/29/2005
Last updated
07/19/2010
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