| Dr Christiaan Erik De Vries, MD | |
|
200 High Park Ave, Goshen, IN 46526-4810 | |
| (574) 364-1000 | |
| Not Available |
| Full Name | Dr Christiaan Erik De Vries |
|---|---|
| Gender | Male |
| Speciality | Pathology |
| Experience | 17 Years |
| Location | 200 High Park Ave, Goshen, Indiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528349669 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 01078367A (Indiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Goshen Hospital | Goshen, IN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Goshen Hospital Association Inc | 5991770695 | 10 |
| Entity Name | Northeast Indiana Urology. P.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619920295 PECOS PAC ID: 5395641914 Enrollment ID: O20031212000174 |
| Entity Name | Goshen Hospital Association Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740268846 PECOS PAC ID: 5991770695 Enrollment ID: O20040826001171 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Christiaan Erik De Vries, MD 200 High Park Ave, Goshen, IN 46526-4810 Ph: (574) 364-1000 | Dr Christiaan Erik De Vries, MD 200 High Park Ave, Goshen, IN 46526-4810 Ph: (574) 364-1000 |
Victoria L.s. Owens, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 200 High Park Ave, Goshen, IN 46526 Phone: 574-364-1000 | |
Shruti Abhijit Shukla, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 200 High Park Ave, Goshen, IN 46526 Phone: 574-533-2141 Fax: 574-364-2777 |