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1861508483
MANOJ R SURYAWALA
FORT WAYNE, IN
NPI
1861508483
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: IN 01052547A)
Enumeration Date
2006-08-23
Last Update Date
2007-07-08
Business Address
-- MANOJ R SURYAWALA m.d
2121 LAKE AVE
FORT WAYNE, IN 46805-5100
Phone number: 260-426-5431
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Mailing Address
-- MANOJ R SURYAWALA m.d
2121 LAKE AVE
FORT WAYNE, IN 46805-5100
Phone number: 260-426-5431
Copy
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