NPI 1194913228

Psychiatric Services P C

Organisation Psychiatry Physician Fort Wayne, IN

Practice location

Address: 800 Broadway STE 208, Fort Wayne, IN 46802-2149
Phone: (260) 425-3204
Fax: (260) 425-3206
Mailing address: PO Box 40139, Fort Wayne, IN 46804-0139

Authorised official

Name: Mahender Reddy Surakanti
Title: M.D.
Phone: (260) 425-3204

Registered specialties

Psychiatry Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2084P0800X Licence 01057700A (IN)

Other Psychiatry & Neurology providers in Indiana →

Registry record

NPI: 1194913228
Entity type: Organization
NPI issued: 15 Oct 2007
Record last updated: 5 Feb 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.