Individual
KURTIS DEJONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5215 HOLY CROSS PKWY, EMERGENCY DEPARTMENT, MISHAWAKA, IN 46545-1469
(574) 335-5000
Mailing address
5215 HOLY CROSS PKWY, EMERGENCY DEPARTMENT, MISHAWAKA, IN 46545-1469
(574) 335-5000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01039621
IN
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
01039621
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000190295
ANTHEM
IN
05
—
104943838
—
MI
05
—
200022520
—
IN
01
—
930102831
RAIL ROAD MEDICARE
IN
Enumeration date
04/26/2006
Last updated
12/16/2011
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us