Individual
ERICK MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
11109 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845-1701
(260) 266-1000
Mailing address
608 UNION CHAPEL RD, FORT WAYNE, IN 46845-9357
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10003938A
IN
Other
Enumeration date
01/09/2023
Last updated
02/16/2023
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