Organization
INDIANA PSYCHIATRIC ASSOCIATES LLC
Active
Other names
QAM, QPM, Indiana TMS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SATYA KISHORE GUTTA MD (AUTHORIZED OFFICIAL)
(260) 208-9676
Entity
Organization
Contact information
Practice address
4656 W JEFFERSON BLVD STE 201, FORT WAYNE, IN 46804-6857
(978) 000-0001
Mailing address
4656 W JEFFERSON BLVD STE 201, FORT WAYNE, IN 46804-6857
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
Other
Enumeration date
09/28/2021
Last updated
02/18/2022
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