| Doctor Name: | DR. MEREDITH KATHERINE WIERMAN |
| NPI Number: | 1477762680 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.O. |
| License Number: | 5101015213 |
| Business Practice Address: | 611 E Douglas Rd Ste 309 Mishawaka, IN - 465451467 |
| Business Phone Number: | 5743356232 |
| Business Fax Number: | 5743356233 |
| Mailing Address: | Po Box 6309, SOUTH BEND |
| State: | IN |
| Postal Code: | 466606309 |
| Phone Number: | 5743358700 |
| Fax Number: | 5743350760 |
| NPI Enumeration Date: | 05/22/2007 |
| NPI Last Update Date: | 05/11/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 5101015213 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |