Crevecoeur, Guy G

Crevecoeur, Guy G is an individual health care provider with primary practice located at 11141 Parkview Plaza Dr Ste 300 , Fort Wayne IN 46845-1715. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as his primary health care specialty. Crevecoeur, Guy G can be contacted via phone (260) 490-7111.

Contact Information

Primary practice address
11141 Parkview Plaza Dr Ste 300 Fort Wayne IN 46845-1715
Phone: (260) 490-7111
Fax: (260) 490-2286
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 01065385A Indiana

Profile Details

NPI number 1124029079
LBN Legal business name Crevecoeur, Guy G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2005
Last updated Oct 20th, 2022 - 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 1124029079 NPPES
New York MEDICAID 01580914
New York MEDICAID 200901990

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