Individual
MARK A. PIERCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11123 PARKVIEW PLAZA DR STE 106, FORT WAYNE, IN 46845-1707
(260) 672-6550
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01044717A
IN
208000000X
Pediatrics Physician
01044717A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000112353
ANTHEM
IL
01
—
000000207187
ANTHEM
IN
01
—
00001719959 07
UNITED HEALTHCARE
—
01
—
11041
PHYSICIANS HEALTH PLAN
IN
05
—
200110180
—
IN
01
—
3937240024
MEDICARE DMEPOS
IN
01
—
7469262
AETNA
—
Enumeration date
12/27/2005
Last updated
11/16/2022
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