Organization
FORT WAYNE DERMATOLOGY CONSULTANTS INC
Active
Other names
Fort Wayne Dermatology Cons Inc
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD C SARKISIAN M.D. (PRESIDENT)
(260) 436-8000
Entity
Organization
Contact information
Practice address
7881 CARNEGIE BLVD, FORT WAYNE, IN 46804-5792
(260) 436-8000
(260) 432-5587
Mailing address
7881 CARNEGIE BLVD, FORT WAYNE, IN 46804-5792
(260) 436-8000
(260) 432-5587
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
208200000X
Plastic Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200459670A
—
IN
01
—
4463426
AETNA
—
01
—
DA4850
MEDICARE RAIL ROAD
—
Enumeration date
10/10/2006
Last updated
09/27/2021
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