Search › Indiana › 207Q00000X
Melvin Susanto, MD
NPI 1558939629 · on the registry since 2021
Practice
- Address
- 12404 Lima Crossing Dr
Fort Wayne, IN 46818 - Phone
- (260) 458-3740
- Fax
- (260) 458-3741
- Clinicians at this address
- 5
Registry record
- Primary taxonomy
- 207Q00000X
207Q00000X
- Licence states on file
- IN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-09-09
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Indiana