Organization
VALLEY EMERGENCY PHYSICIANS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KURTIS J DEJONG MD (PRESIDENT)
(574) 335-5000
Entity
Organization
Contact information
Practice address
5215 HOLY CROSS PKWY, EMERGENCY DEPARTMENT, MISHAWAKA, IN 46545-1469
(574) 335-5000
Mailing address
3371 CLEVELAND ROAD EXT, SUITE 210, SOUTH BEND, IN 46628-9780
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100221820
—
IN
Enumeration date
05/25/2006
Last updated
11/17/2011
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