Individual
DANIEL J TRIEZENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
420 W 4TH ST, MISHAWAKA, IN 46544-1948
(219) 462-7173
(574) 307-7692
Mailing address
420 W 4TH ST, MISHAWAKA, IN 46544-1948
(574) 307-7673
(574) 307-7692
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01050823
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200239800
—
IN
Enumeration date
10/20/2006
Last updated
09/28/2016
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