SAMUEL VINCENT DISMUKE

FORT WAYNE, IN
NPI1235631557
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: IN  10002437A)
Enumeration Date2018-03-02
Last Update Date2018-10-30
Business Address
SAMUEL VINCENT DISMUKE PA-C
5050 N CLINTON ST
FORT WAYNE, IN 46825-5886
Phone number: 260-484-8551
Mailing Address
SAMUEL VINCENT DISMUKE PA-C
5052 N CLINTON ST
FORT WAYNE, IN 46825-5822
Phone number: 260-484-8551
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