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NPI Code Detail

MEDICARE: NICHOLAS TODORAN MSW

MEDICARE: NICHOLAS TODORAN MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker34008126AIN

General Provider Information

NPI Number : 1003369273
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS TODORAN MSW
Provider Business Mailing Address
First Line : 11109 PARKVIEW PLAZA DR # 117
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1701
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1909 CAREW ST
Second Line :
City : FORT WAYNE
State : IN
Zip : 46805-4707
Country : US
Telephone Number : 260-481-2800
Fax Number : 260-969-8442
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2016
Last Update Date : 06/16/2022

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