Individual
LYDIA K MERTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
608 OAKLAND AVE, ELKHART, IN 46516-3819
(574) 523-2127
(574) 522-2192
Mailing address
1130 PROFESSIONAL DR, GOSHEN, IN 46526-3819
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01031929A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100414680
—
IN
Enumeration date
09/04/2008
Last updated
03/07/2023
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