PRIVIA MEDICAL GROUP INDIANA, LLC

MISHAWAKA, IN
NPI1235303165
Other NamePRIMARY CARE AT MISHAWAKA
Other NameEDISON LAKES UROLOGY
Entity TypeOrganization
Authorized ContactTIMOTHY PORSCHE
Managing Partner
574-296-3200
Organization Subpart ?No
Primary Taxonomy261QM1300X Clinic/Center, Multi-Specialty
Enumeration Date2008-04-22
Last Update Date2025-05-12
Business Address
PRIVIA MEDICAL GROUP INDIANA, LLC
410 PARK PL SUITE B
MISHAWAKA, IN 46545-3557
Phone number: 574-855-5800
Mailing Address
PRIVIA MEDICAL GROUP INDIANA, LLC
PO BOX 2968
ELKHART, IN 46515-2968
Phone number: 574-296-3200