SOE NYUNT

FORT WAYNE, IN
NPI1538241898
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207R00000X Internal Medicine
(Licence: NY  217934)
Enumeration Date2006-10-19
Last Update Date2013-04-26
Business Address
-- SOE NYUNT MD
2121 LAKE AVE
FORT WAYNE, IN 46805-5100
Phone number: 260-426-5431
Mailing Address
-- SOE NYUNT MD
5712 RIO CANYON RUN
FORT WAYNE, IN 46825-1406
Phone number: 260-470-9673
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