Individual
TIMOTHY W NUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2016 S MAIN ST, GOSHEN, IN 46526-5236
(574) 533-7600
(574) 533-7666
Mailing address
PO BOX 834, GOSHEN, IN 46527-0834
(574) 364-2875
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01066665A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2009935890
—
IN
Enumeration date
04/10/2007
Last updated
05/17/2024
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