Thomas P Van Den Driessche
NPI #1538349956 in Fort Wayne, Indiana
Provider Information
- NPI Number
- 1538349956
- Entity Type
- Organization
- Organization Name
- Thomas P Van Den Driessche
- Primary Specialty
- Family Medicine
- Enumeration Date
- Nov 14, 2007
- Last Updated
- Nov 14, 2007
Practice Location
- Address
- 3030 LAKE AVE
- Address 2
- SUITE 32
- City
- Fort Wayne
- State
- Indiana
- ZIP Code
- 46805-5428
- Phone
- (260) 424-3134
Authorized Official
- Name
- DR. THOMAS P VAN DEN DRIESSCHE, M.D.
- Title
- OWNER
- Phone
- (260) 424-3134
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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