Provider Demographics
NPI:1427809870
Name:FUZE MEDICAL
Entity type:Organization
Organization Name:FUZE MEDICAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:BRAZZALE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:219-669-1034
Mailing Address - Street 1:9430 WICKER AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHN
Mailing Address - State:IN
Mailing Address - Zip Code:46373-9400
Mailing Address - Country:US
Mailing Address - Phone:219-558-8068
Mailing Address - Fax:877-822-9116
Practice Address - Street 1:9430 WICKER AVE
Practice Address - Street 2:
Practice Address - City:SAINT JOHN
Practice Address - State:IN
Practice Address - Zip Code:46373-9400
Practice Address - Country:US
Practice Address - Phone:219-558-8068
Practice Address - Fax:877-822-9116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-01
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
No2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity MedicineGroup - Multi-Specialty