Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 01062592 | IN |
Y | 207VX0201X | Gynecologic Oncologist | 01062592A | IN |
NPI | 1144302720 |
---|---|
Provider Name | Dr. Iwona Podzielinski |
First Address | Fort Wayne, IN 46845-1701 |
Second Address | Fort Wayne, IN 46845 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2006 |
Last Update Date | 08/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200848870 | (05) | IN |