| St Mary Care Network Porter County Primary Care | |
|
2000 Roosevelt Rd Ste 5 Valparaiso IN 46383-2800 | |
| (219) 464-2123 | |
| (219) 465-0032 |
| Full Name | St Mary Care Network Porter County Primary Care |
|---|---|
| Speciality | Family Medicine |
| Location | 2000 Roosevelt Rd, Valparaiso, Indiana |
| Authorized Official Name and Position | Janice L Ryba (CEO) |
| Authorized Official Contact | 2199420551 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St Mary Care Network Porter County Primary Care 2000 Roosevelt Rd Ste 5 Valparaiso IN 46383-2800 Ph: (219) 464-2123 | St Mary Care Network Porter County Primary Care 2000 Roosevelt Rd Ste 5 Valparaiso IN 46383-2800 Ph: (219) 464-2123 |
| NPI Number | 1245382498 |
|---|---|
| Provider Enumeration Date | 01/17/2007 |
| Last Update Date | 03/30/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245382498 | NPI | - | NPPES |
| 200219530A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
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