Canavati, Isa S

Canavati, Isa S is an individual health care provider with primary practice located at 7956 W Jefferson Blvd , Fort Wayne IN 46804-4140. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Canavati, Isa S can be contacted via phone (260) 436-2416.

Contact Information

Primary practice address
7956 W Jefferson Blvd Fort Wayne IN 46804-4140
Phone: (260) 436-2416
Fax: (260) 436-6936
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 01035042A Indiana

Profile Details

NPI number 1952308413
LBN Legal business name Canavati, Isa S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2005
Last updated Oct 5th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952308413 NPPES
Ohio MEDICAID 0631105
Ohio MEDICAID 2745823
Ohio MEDICAID 100096050
Ohio Other 140001925

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