Organization
NORTHEAST OBSTETRICS & GYNECOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMI A FURNISS (BUSINESS MANAGER)
(260) 426-7755
Entity
Organization
Contact information
Practice address
2414 E STATE BLVD, SUITE 101, FORT WAYNE, IN 46805-4760
(260) 422-7455
(260) 422-0086
Mailing address
2414 E STATE BLVD, SUITE 101, FORT WAYNE, IN 46805-4760
(260) 422-7455
(260) 422-0086
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
07/23/2008
Last updated
07/23/2008
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