Organization
PAUL W MACELLARI PHD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL WARREN MACELLARI PHD (PRESIDENT)
(574) 254-9200
Entity
Organization
Contact information
Practice address
135 RED COACH DR, MISHAWAKA, IN 46545-3145
(574) 254-9200
(574) 254-9202
Mailing address
139 RED COACH DRIVE, MISHAWAKA, IN 46545-3145
(574) 254-9200
(574) 254-9202
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
20040273
IN
Other
Enumeration date
05/21/2015
Last updated
05/21/2015
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