Individual
DR. DAVID M DYCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3301 COUNTY ROAD 6 E, ELKHART, IN 46514-7673
(574) 264-9635
(574) 262-0398
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
(574) 237-6069
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01067738A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200989420
—
IN
01
—
236040061
MEDICARE PTAN
IN
Enumeration date
08/22/2005
Last updated
04/01/2021
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