Organization
PEDIATRIC ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID A RUSK (PRESIDENT)
(260) 436-3789
Entity
Organization
Contact information
Practice address
7910 W JEFFERSON BLVD, STE 201, FORT WAYNE, IN 46804-4159
(260) 436-3789
(260) 436-2703
Mailing address
7910 W JEFFERSON BLVD, STE 201, FORT WAYNE, IN 46804-4159
(260) 436-3789
(260) 436-2703
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01025325A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100049720A
—
IN
Enumeration date
06/13/2005
Last updated
04/10/2024
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