| Mishawaka Clinic, P.c. | |
|
303 S. Main St. Suite 212 Mishawaka IN 46544 | |
| (574) 254-0800 | |
| (574) 254-0812 |
| Full Name | Mishawaka Clinic, P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 303 S. Main St., Mishawaka, Indiana |
| Authorized Official Name and Position | James E. Reidy (PRESIDENT) |
| Authorized Official Contact | 5742540800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mishawaka Clinic, P.c. 303 S. Main St. Suite 212 Mishawaka IN 46544 Ph: (574) 254-0800 | Mishawaka Clinic, P.c. 303 S. Main St. Suite 212 Mishawaka IN 46544 Ph: (574) 254-0800 |
| NPI Number | 1972776938 |
|---|---|
| Provider Enumeration Date | 04/10/2008 |
| Last Update Date | 04/08/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972776938 | NPI | - | NPPES |
| 1497794010 | Other | IN | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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