| Privia Medical Group Indiana, Llc | |
|
410 Park Pl Ste A Mishawaka IN 46545-3557 | |
| (574) 252-0667 | |
| (574) 807-8845 |
| Full Name | Privia Medical Group Indiana, Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 410 Park Pl Ste A, Mishawaka, Indiana |
| Authorized Official Name and Position | Kevin R Boyer (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5742963200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Privia Medical Group Indiana, Llc 410 Park Pl Suite A Mishawaka IN 46545-3557 Ph: (574) 252-0667 | Privia Medical Group Indiana, Llc 410 Park Pl Ste A Mishawaka IN 46545-3557 Ph: (574) 252-0667 |
| NPI Number | 1851497945 |
|---|---|
| Provider Enumeration Date | 09/15/2006 |
| Last Update Date | 05/12/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851497945 | NPI | - | NPPES |
| 100466600 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Saint Joseph Pace Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 250 E Day Rd, Mishawaka, IN 46545 Phone: 574-247-8700 | |
Allied Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 314 W Catalpa Dr, Suite A, Mishawaka, IN 46545 Phone: 574-255-1522 Fax: 574-255-1540 | |
Honor Physicians, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3809 N Main St Ste 100, Mishawaka, IN 46545 Phone: 574-520-1700 Fax: 833-989-0916 | |
Novia Careclinics, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 214 Indiana Ave, Mishawaka, IN 46544 Phone: 317-472-7568 Fax: 574-855-1565 | |
Saint Joseph Community Hospital Of Mishawaka Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 Lincoln Way W, Mishawaka, IN 46544 Phone: 574-252-3699 Fax: 574-252-3698 | |
Privia Medical Group Indiana, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 Park Pl, Suite B, Mishawaka, IN 46545 Phone: 574-855-5800 Fax: 574-855-5805 | |
Glenn S. Wheet, Md, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 900 Lincoln Way W, Mishawaka, IN 46544 Phone: 574-259-6937 Fax: 574-259-6939 |