Provider Demographics
NPI:1376955070
Name:FERTILITY AND MIDWIFERY CARE CENTER LLC
Entity Type:Organization
Organization Name:FERTILITY AND MIDWIFERY CARE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:B
Authorized Official - Last Name:STROUD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:260-222-7401
Mailing Address - Street 1:10228 DUPONT CIRCLE DR E
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-1611
Mailing Address - Country:US
Mailing Address - Phone:260-222-7401
Mailing Address - Fax:
Practice Address - Street 1:10228 DUPONT CIRCLE DR E
Practice Address - Street 2:SUITE 100
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-1611
Practice Address - Country:US
Practice Address - Phone:260-222-7401
Practice Address - Fax:260-209-5956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-29
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty