| Primary Care PC | |
|
3125 Willowcreek Road Portage IN 46368 | |
| (219) 762-3175 | |
| (219) 763-3092 |
| Full Name | Primary Care PC |
|---|---|
| Speciality | Family Medicine |
| Location | 3125 Willowcreek Road, Portage, Indiana |
| Authorized Official Name and Position | Kenneth Walter Blumenthal (PRESIDENT) |
| Authorized Official Contact | 2197623175 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care PC 3125 Willowcreek Road Portage IN 46368 Ph: (219) 762-3175 | Primary Care PC 3125 Willowcreek Road Portage IN 46368 Ph: (219) 762-3175 |
| NPI Number | 1013029883 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 08/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013029883 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 50004219A (Indiana) | Primary |
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