Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Retina Institute of Indiana Surgery Center, LLC

Organization Ophthalmology Physician · NPI 1730442559

Retina Institute of Indiana Surgery Center, LLC is an Ophthalmology Physician in Fort Wayne, Indiana. Licensed in Indiana. Registered with an NPI since 2012.

Licensed in
IN
In the registry since
2012
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

11192 Diebold Rd
Fort Wayne, IN 46845-9662
Phone: (260) 483-9500
Fax: (260) 483-9511
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ambulatory Surgical Clinic/Center (primary) Taxonomy 261QA1903X · Licence 13 012741 1 (IN)
Ophthalmology Physician Taxonomy 207W00000X · Licence 01058885A (IN)

Record details

NPI number1730442559
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gohar Salam — Sole Mbr · (260) 483-9500
NPI enumeratedJune 18, 2012
Last updated in NPPESMarch 3, 2016
Mailing address11192 Diebold Rd, Fort Wayne, IN 46845-9662

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