NPI 1013910041 · live from the CMS NPI Registry
Dominick Detommaso, D.P.M.
Podiatrist, Foot & Ankle Surgery in Fort Wayne, IN. National Provider Identifier 1013910041, active.
NPI record
| NPI | 1013910041 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist, Foot & Ankle Surgery 213ES0103X |
| Practice location | 7601 W Jefferson Blvd, Fort Wayne, IN 46804 |
| Practice phone | 260-436-8686 |
| Enumerated | May 23, 2005 |
| Last updated | March 22, 2016 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist, Foot & Ankle Surgery primary | 213ES0103X | 07000410A (IN) |
| Podiatrist | 213E00000X | 07000410A (IN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.