| Nova Physician Group Pllc | |
|
436 E Washington Blvd Fort Wayne IN 46802-3210 | |
| (260) 298-6240 | |
| (206) 474-3157 |
| Full Name | Nova Physician Group Pllc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 436 E Washington Blvd, Fort Wayne, Indiana |
| Authorized Official Name and Position | Terrence Morton (SR. MEDICAL DIRECTOR) |
| Authorized Official Contact | 7737339730 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nova Physician Group Pllc 30 W Monroe St Ste 1200 Chicago IL 60603-2420 Ph: (773) 352-1515 | Nova Physician Group Pllc 436 E Washington Blvd Fort Wayne IN 46802-3210 Ph: (260) 298-6240 |
| NPI Number | 1528815396 |
|---|---|
| Provider Enumeration Date | 05/01/2024 |
| Last Update Date | 05/01/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528815396 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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