Individual
PHILIP RICHARD PERSINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6301 UNIVERSITY COMMONS STE 360, SOUTH BEND, IN 46635-3500
(574) 204-6522
Mailing address
211 N EDDY ST, SOUTH BEND, IN 46617-3096
(574) 204-6522
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
01089151A
IN
Other
Enumeration date
04/02/2018
Last updated
07/13/2023
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