| Family Medicine Faculty Physicians | |
|
611 E Douglas Rd, Ste 406 Family Medicine Faculty Physicians Mishawaka IN 46545-1468 | |
| (574) 335-6580 | |
| (574) 335-0818 |
| Full Name | Family Medicine Faculty Physicians |
|---|---|
| Speciality | Family Medicine |
| Location | 611 E Douglas Rd, Ste 406, Mishawaka, Indiana |
| Authorized Official Name and Position | Robert Sink (VICE PRESIDENT OF FINANCE) |
| Authorized Official Contact | 5743355000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medicine Faculty Physicians 707 Cedar St, Ste 200 Family Medicine Faculty Physicians (provider Services) South Bend IN 46617-2057 Ph: (574) 335-8700 | Family Medicine Faculty Physicians 611 E Douglas Rd, Ste 406 Family Medicine Faculty Physicians Mishawaka IN 46545-1468 Ph: (574) 335-6580 |
| NPI Number | 1144580150 |
|---|---|
| Provider Enumeration Date | 05/23/2012 |
| Last Update Date | 08/21/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144580150 | NPI | - | NPPES |
| 100382210C | Medicaid | IN | |
| CC0460 | Other | IN | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207VM0101X | Obstetrics & Gynecology - Maternal & Fetal Medicine | (* (Not Available)) | Secondary |
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