Individual
MICAH SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
401 N SAWYER RD STE C, KENDALLVILLE, IN 46755-2568
(260) 347-2833
(260) 347-1724
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
07001372A
IN
213E00000X
Podiatrist
Primary
99086926A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300014870
—
IN
Enumeration date
05/09/2018
Last updated
03/02/2026
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