Individual
SEAN MAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3512 STELLHORN RD, FORT WAYNE, IN 46815-4631
(260) 483-9081
(260) 483-9196
Mailing address
3512 STELLHORN RD, FORT WAYNE, IN 46815-4631
(260) 483-9081
(260) 483-9196
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28222652A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71007079A
IN
Other
Enumeration date
04/12/2017
Last updated
05/08/2017
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