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1538279856
SUSEELA DORAVARI
FORT WAYNE, IN
NPI
1538279856
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
207R00000X Internal Medicine
(Licence: IN 01041370)
Enumeration Date
2006-08-30
Last Update Date
2007-07-08
Business Address
-- SUSEELA DORAVARI MD
2121 LAKE AVE
FORT WAYNE, IN 46805-5100
Phone number: 260-426-5431
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Mailing Address
-- SUSEELA DORAVARI MD
10510 INDIAN RIDGE DR
FORT WAYNE, IN 46814-9090
Phone number: 260-426-5431
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