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General NPI Number Information
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NPI Number | 1831160001
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Entity Type | Individual
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Provider Name | JOHN NOVAK PASALICH MD
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Gender | Male
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Dates
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Enumeration Date | 01/27/2006
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 7221 ENGLE RD STE 220
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City | FORT WAYNE
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State | IN
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Zip | 46804-2233
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Country | US
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Telephone | 260-469-8223
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Fax | 260-469-8201
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Provider Business Mailing Address
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Address Line | 7221 ENGLE RD STE 220
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City | FORT WAYNE
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State | IN
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Zip | 46804-2233
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Country | US
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Telephone | 260-469-8223
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Fax | 260-432-4969
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 01024054A
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License Number State | IN
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