MICHELLE ELISE WIESE

FORT WAYNE, IN
NPI1003348343
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: IN  01093232A)
Additional Taxonomies2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: WA  MD60988236)
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2017-03-28
Last Update Date2024-06-28
Business Address
MICHELLE ELISE WIESE MD
909 E STATE BLVD
FORT WAYNE, IN 46805-3404
Phone number: 260-481-2700
Mailing Address
MICHELLE ELISE WIESE MD
11109 PARKVIEW PLAZA DR # 117
FORT WAYNE, IN 46845-1701
Phone number: