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1174034425
PETER J EDGAR
FORT WAYNE, IN
NPI
1174034425
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IN 10002364A)
Enumeration Date
2017-10-13
Last Update Date
2022-10-10
Business Address
PETER J EDGAR
3909 NEW VISION DR
FORT WAYNE, IN 46845-1725
Phone number: 260-469-6610
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Mailing Address
PETER J EDGAR
11109 PARKVIEW PLAZA DR # 117
FORT WAYNE, IN 46845-1701
Phone number:
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