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Individual

MAREIKE I FERGUSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
2350 MIAMI VALLEY DR STE 500, CENTERVILLE, OH 45459-4780
(937) 293-1622
(937) 245-6308
Mailing address
6680 POE AVE STE 200, DAYTON, OH 45414-2855
(937) 280-8400
(937) 280-8373

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.004810RX
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0187094
OH
Enumeration date
09/21/2016
Last updated
05/07/2026
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