Individual
MRS. DIANA E PEREZ - SOLANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
611 E DOUGLAS RD STE 207, MISHAWAKA, IN 46545-1465
(574) 335-6850
(574) 335-0849
Mailing address
707 CEDAR ST STE 405, SOUTH BEND, IN 46617-2059
(574) 335-6850
(574) 335-0849
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002769A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102555349
ANTHEM
IN
05
—
300035174
—
IN
Enumeration date
12/19/2011
Last updated
07/17/2023
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