Individual
DR. KIMBERLY SUE VAN ELK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 HIGH PARK AVE, GOSHEN, IN 46526-4810
(574) 364-1000
Mailing address
7520 TOSCANA CT, GRANGER, IN 46530-8056
(765) 748-2309
(574) 233-3125
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01073789
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201110000
—
IN
Enumeration date
05/04/2011
Last updated
04/26/2021
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