Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JONATHAN DETOMMASO, DPM
Active Sole ProprietorDR. JONATHAN DETOMMASO, DPM is a Foot & Ankle Surgery Podiatrist healthcare provider located in FORT WAYNE, Indiana. NPI 1033476304 is currently active in the NPPES registry. Verify at CMS.
Foot & Ankle Surgery Podiatrist · FORT WAYNE, IN
Registration Details
- NPI Number
- 1033476304
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 11, 2012 (14.302485416506 yrs)
- Last Updated
- Nov 7, 2016
- Licenses
-
07001204A (IN)07001204A (IN)
- Sole Proprietor
- Yes
Practice Information
- Address
-
7601 W JEFFERSON BLVDFORT WAYNE, IN, 468044133Browse IN providers · Browse ZIP 46804
- Phone
- 2604368686
- Fax
- 2604368585
- Primary Specialty
-
Foot & Ankle Surgery Podiatrist
213ES0103X
- Additional Specialty
- Foot & Ankle Surgery Podiatrist
Other Foot & Ankle Surgery Podiatrist Providers in FORT WAYNE, IN
| Name | Credential | NPI |
|---|---|---|
| DR. DOMINICK DETOMMASO | D.P.M. | 1013910041 |
| JONATHAN VN NORTON | D.P.M. | 1609879683 |
| GAGE MANNING CAUDELL | D.P.M. | 1013188291 |
| DR. JACQUELINE MONROE | D.P.M | 1912276361 |
| ASHLEY M BOJRAB | DPM | 1275892952 |
| KRISTIN RUTH TOLIVER | D.P.M. | 1720420748 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.