Three Rivers Dermatology, Llc in Fort Wayne - Specialist
Three Rivers Dermatology, Llc - NPI 1992991475
Three Rivers Dermatology, Llc is a Specialist in Fort Wayne, Indiana. Three Rivers Dermatology, Llc practices all healthcare services and medical treatments related to Specialist. The NPI Number for Three Rivers Dermatology, Llc is 1992991475. The last update date is 2020-06-12.
Three Rivers Dermatology, Llc's current location address is 5650 Coventry Ln, Fort Wayne, Indiana. You can contact this provider via phone number 2604369696 and fax number 2604369424. The mailing address for Three Rivers Dermatology, Llc is 5650 Coventry Ln, Fort Wayne, Indiana. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Three Rivers Dermatology, Llc |
|---|---|
| Address | 5650 Coventry Ln, Fort Wayne, Indiana |
| Phone Number | 2604369696 |
| Fax Number | 2604369424 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CEO/OWNER |
|---|---|
| Authorized Official Name | Sassmannshausen Walter Jeffrey |
| Credentials | M.D. |
| Telephone Number | 2604369696 |
NPI Number Detail
| NPI Number | 1992991475 |
|---|---|
| Provider Enumeration Date | 2007-09-19 |
| Last Updated Date | 2020-06-12 |
Provider Mailing Address Detail
| Address | 5650 Coventry Ln |
|---|---|
| City | Fort Wayne |
| State | Indiana (IN) |
| Post Code | 468047140 |
| Phone Number | 2604369696 |
| Fax Number | 2604369424 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
|
Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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Post Comment/ Review Below
What is the Three Rivers Dermatology, Llc's unique identification number?
The Three Rivers Dermatology, Llc has been assigned the NPI (National Provider Identifier) Number 1992991475 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please share the complete physical address where Three Rivers Dermatology, Llc is geographically located?
The Three Rivers Dermatology, Llc is physically situated at the following location: 5650 Coventry Ln, Fort Wayne, IN, 468047140.
What is the Three Rivers Dermatology, Llc's specialty and taxonomy code?
The Three Rivers Dermatology, Llc's specialty is Specialist, and the corresponding taxonomy code is 174400000X.
On what date did the Three Rivers Dermatology, Llc receive its 1992991475 assignment from the Centers for Medicare & Medicaid Services?
The Three Rivers Dermatology, Llc was assigned its 1992991475 by the Centers for Medicare & Medicaid Services on 2007-09-19.
When was the information pertaining to Three Rivers Dermatology, Llc most recently updated or revised?
The details related to Three Rivers Dermatology, Llc, including its address, specialty, and other relevant information, were last updated or revised on 2020-06-12.
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