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Organization
MISHAWAKA CLINIC, P.C.
Active
Organization
MISHAWAKA CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES E. REIDY M.D. (PRESIDENT)
(574) 254-0800
Entity
Organization
Contact information
Practice address
303 S. MAIN ST., SUITE 212, MISHAWAKA, IN 46544
(574) 254-0800
(574) 254-0812
Mailing address
303 S. MAIN ST., SUITE 212, MISHAWAKA, IN 46544
(574) 254-0800
(574) 254-0812
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/10/2008
Last updated
04/08/2011
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