Organization
FORT WAYNE DERMATOLOGY CONSULTANTS INC
Active
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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