Individual
MELINDA PEISERICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7900 W JEFFERSON BLVD STE 306, FORT WAYNE, IN 46804-4128
(260) 702-8055
Mailing address
7900 W JEFFERSON BLVD STE 306, FORT WAYNE, IN 46804-4128
(260) 458-3610
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10003230A
IN
Other
Enumeration date
07/28/2020
Last updated
04/23/2021
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