| Paul W Macellari Phd Pc | |
|
135 Red Coach Dr Mishawaka IN 46545-3145 | |
| (574) 254-9200 | |
| (574) 254-9202 |
| Full Name | Paul W Macellari Phd Pc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 135 Red Coach Dr, Mishawaka, Indiana |
| Authorized Official Name and Position | Paul Warren Macellari (PRESIDENT) |
| Authorized Official Contact | 5742549200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paul W Macellari Phd Pc 139 Red Coach Drive Mishawaka IN 46545-3145 Ph: (574) 254-9200 | Paul W Macellari Phd Pc 135 Red Coach Dr Mishawaka IN 46545-3145 Ph: (574) 254-9200 |
| NPI Number | 1285013474 |
|---|---|
| Provider Enumeration Date | 05/21/2015 |
| Last Update Date | 05/21/2015 |
| Medicare PECOS PAC ID | 1153642640 |
|---|---|
| Medicare Enrollment ID | O20150609002660 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285013474 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 20040273 (Indiana) | Primary |
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