Organization
NORTHEAST INDIANA PEDIATRIC SPECIALISTS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERYL L. ANDERSON (MANAGER)
(260) 483-0688
Entity
Organization
Contact information
Practice address
11123 PARKVIEW PLAZA DR, STE # 102, FORT WAYNE, IN 46845-1707
(260) 483-0688
(260) 483-0798
Mailing address
PO BOX 5191, FORT WAYNE, IN 46895-5191
(260) 483-0688
(260) 483-0798
Taxonomy
Speciality
Code
Description
License number
State
2080P0208X
Pediatric Infectious Diseases Physician
Primary
50004150A
IN
Other
Enumeration date
10/18/2007
Last updated
10/18/2007
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