Healthcare Provider Details

I. General information

NPI: 1053471250
Provider Name (Legal Business Name): ANTHONY M SAVO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 04/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11123 PARKVIEW PLAZA DR STE 201
FORT WAYNE IN
46845-1707
US

IV. Provider business mailing address

1320 SWEETWATER CV UNIT 203
NAPLES FL
34110-4166
US

V. Phone/Fax

Practice location:
  • Phone: 260-425-5950
  • Fax: 260-425-5165
Mailing address:
  • Phone: 203-631-4175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number266532
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number266532
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number266532
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number266532
License Number StateNY
# 5
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number01047573A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: