Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MELVIN SUSANTO, MD
ActiveMELVIN SUSANTO, MD is a Family Medicine healthcare provider located in FORT WAYNE, Indiana. NPI 1558939629 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · FORT WAYNE, IN
Registration Details
- NPI Number
- 1558939629
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 15, 2021 (5.166318334422 yrs)
- Last Updated
- Sep 9, 2024
- License
-
01091229A (IN)
Practice Information
- Address
-
12404 LIMA CROSSING DRFORT WAYNE, IN, 468180202Browse IN providers · Browse ZIP 46818
- Phone
- 2604583740
- Fax
- 2604583741
- Primary Specialty
-
Family Medicine
207Q00000X
Other Family Medicine Providers in FORT WAYNE, IN
| Name | Credential | NPI |
|---|---|---|
| DR. JOSEPH ROBERT HUGUENARD | MD | 1598767782 |
| TODD ROBERT PAGE | MD | 1184622367 |
| LYNN VAN VALER FAUR | MD | 1326047721 |
| DENISE M SMITH | DO | 1912907445 |
| WILLIAM D GOUDY | D.O. | 1568462935 |
| ,BIRUTE L PUMPUTIS | MD | 1326048455 |
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.