OrganizationActive
Indiana Plastic Surgery Center, PC
NPI 1174861454 · Medical Specialty Clinic/Center · Fort Wayne, IN
Provider details
- NPI number
- 1174861454
- Entity type
- Organization
- Primary specialty
- Medical Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Robert Severinac, President(260) 489-0099
- License
- 01043388A (IN)
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
10020 Dupont Circle Ct
Suite 100
Fort Wayne, IN 46825-1620
Phone: (260) 489-0099
Fax: (260) 489-0066
Approximate (ZIP-level) locationGet directions
Mailing address
10020 Dupont Circle Ct
Fort Wayne, IN 46825-1620
Registry dates
- Enumerated
- 2013-01-22
- Last updated
- 2013-01-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.