Organization
NORTHEAST INDIANA COLON RECTAL SURGEONS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL J. RAIMAN M.D. (OWNER/PRACTITIONER)
(260) 489-8898
Entity
Organization
Contact information
Practice address
11141 PARKVIEW PLAZA DR, SUITE 310, FORT WAYNE, IN 46845-1701
(260) 489-8898
(260) 373-4695
Mailing address
11141 PARKVIEW PLAZA DR, SUITE 310, FORT WAYNE, IN 46845-1701
(260) 489-8898
(260) 373-4695
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
50004032A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2053852
—
OH
Enumeration date
10/31/2005
Last updated
02/28/2008
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