Organization
SEVEN HILLS OB-GYN ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN J FERNANDEZ (VP RCM)
(516) 972-1568
Entity
Organization
Contact information
Practice address
10307 DUPONT CIRCLE DR W STE A, FORT WAYNE, IN 46825-1633
(260) 458-3440
(260) 458-3441
Mailing address
11595 N MERIDIAN ST STE 375, CARMEL, IN 46032-3950
(317) 575-7304
(317) 575-7333
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
367A00000X
Advanced Practice Midwife
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300062477
—
IN
Enumeration date
04/26/2022
Last updated
09/13/2022
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