Individual
KELLY MARSZALEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
611 E DOUGLAS RD STE 407, MISHAWAKA, IN 46545-1468
(574) 335-6500
(574) 335-0772
Mailing address
6021 MISSION TRL APT 4, GRANGER, IN 46530-4021
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01078730A
IN
207Q00000X
Family Medicine Physician
11017605A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300005699
—
IN
Enumeration date
06/11/2014
Last updated
05/25/2023
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