OrganizationActive
Great Lakes Pediatric Surgeons, Inc.
NPI 1669455267 · Pediatric Surgery Physician · Fort Wayne, IN
Provider details
- NPI number
- 1669455267
- Entity type
- Organization
- Primary specialty
- Pediatric Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- David Smith, President(260) 469-7337
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
7613 W Jefferson Blvd Ste 200
Fort Wayne, IN 46804-4182
Phone: (260) 469-7337
Fax: (260) 469-7340
Approximate (ZIP-level) locationGet directions
Mailing address
7613 W Jefferson Blvd Ste 200
Fort Wayne, IN 46804-4182
Registry dates
- Enumerated
- 2005-11-29
- Last updated
- 2008-03-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.