| Michiana Primary Care Llc | |
|
615 Fulmer Rd Mishawaka IN 46544 | |
| (574) 252-3085 | |
| (574) 252-5906 |
| Full Name | Michiana Primary Care Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 615 Fulmer Rd, Mishawaka, Indiana |
| Authorized Official Name and Position | James Flynn (CEO) |
| Authorized Official Contact | 5742316800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michiana Primary Care Llc 4455 Edison Lakes Pkwy Mishawaka IN 46545-1442 Ph: (574) 231-6800 | Michiana Primary Care Llc 615 Fulmer Rd Mishawaka IN 46544 Ph: (574) 252-3085 |
| NPI Number | 1639480643 |
|---|---|
| Provider Enumeration Date | 06/24/2010 |
| Last Update Date | 07/17/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639480643 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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