Individual
MEREDITH ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11109 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845-1701
(260) 266-1700
Mailing address
608 UNION CHAPEL RD, FORT WAYNE, IN 46845-9357
(260) 824-4440
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002623A
IN
Other
Enumeration date
11/23/2018
Last updated
06/01/2024
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