Organization
DENNIS L. FAST MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENNIS LEE FAST M.D. (PRESIDENT)
(765) 622-0003
Entity
Organization
Contact information
Practice address
350 JH WALKER DR, SUITE 110, PENDLETON, IN 46064-8750
(765) 622-0003
(765) 778-7535
Mailing address
350 JH WALKER DR, SUITE 110, PENDLETON, IN 46064-8750
(765) 622-0003
(765) 778-7535
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01028579A
IN
Other
Enumeration date
04/13/2012
Last updated
04/13/2012
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