Individual
NICHOLAS LEONOWICZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10343 DAWSONS CREEK BLVD STE A, FORT WAYNE, IN 46825
(260) 206-9600
Mailing address
10343 DAWSONS CREEK BLVD STE A, FORT WAYNE, IN 46825-1906
(260) 203-9600
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01080188A
IN
207P00000X
Emergency Medicine Physician
4301108207
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0378205
—
OH
Enumeration date
07/02/2015
Last updated
10/09/2025
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