NPI 1720790330

Radiant Dermatology Associates LLC

Organisation Dermatology Physician Fort Wayne, IN

Practice location

Address: 722 E Till Rd STE 102, Fort Wayne, IN 46825-2066
Phone: (260) 487-4065

Authorised official

Name: Dara Spearman
Title: Owner
Phone: (260) 487-4065

Registered specialties

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X

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Registry record

NPI: 1720790330
Entity type: Organization
NPI issued: 15 Dec 2022
Record last updated: 15 Dec 2022

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.