Organization
FORT WAYNE MEDICAL ONCOLOGY AND HEMATOLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY GIZE MD (MD - OWNER)
(260) 484-8830
Entity
Organization
Contact information
Practice address
2514 E DUPONT ROAD SUITE 100, FORT WAYNE, IN 46825-1619
(260) 484-8830
(260) 483-1911
Mailing address
2514 E DUPONT ROAD SUITE 100, FORT WAYNE, IN 46825-1619
(260) 484-8830
(260) 483-1911
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
60005894
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100053330
—
IN
Enumeration date
12/12/2006
Last updated
08/01/2019
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