Healthcare Provider Details

I. General information

NPI: 1477762680
Provider Name (Legal Business Name): MEREDITH KATHERINE WIERMAN SCHMIDT DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEREDITH WIERMAN DO

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 ARCADE AVE STE 210
ELKHART IN
46514-2485
US

IV. Provider business mailing address

3245 HEALTH DR STE 100
GRANGER IN
46530-1380
US

V. Phone/Fax

Practice location:
  • Phone: 574-389-5656
  • Fax: 574-523-7891
Mailing address:
  • Phone: 574-647-1840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number5101015213
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number02003332
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: