| NPI | 1366433369 |
|---|---|
| Doing Business As | FORT WAYNE NEUROSURGERY |
| Entity Type | Organization |
| Authorized Contact | ISA S CANAVATI President 260-436-2416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 1041C0700X Social Worker, Clinical | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2018-12-07 |