Organization
GREG M. MIELKE, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BETTY DAWN YODER (OFFICE MANAGER)
(574) 523-0885
Entity
Organization
Contact information
Practice address
1209 HARRISON ST, ELKHART, IN 46516-2139
(574) 523-0885
(574) 523-0382
Mailing address
1209 HARRISON ST, ELKHART, IN 46516-2139
(574) 523-0885
(574) 523-0382
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0134860A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100113720
—
IN
Enumeration date
11/10/2008
Last updated
11/10/2008
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