Organization
MICHIANA INTERVENTIONAL AND VASCULAR SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONNIE COATES (MANAGER)
(574) 210-2473
Entity
Organization
Contact information
Practice address
611 E DOUGLAS RD STE 200, MISHAWAKA, IN 46545-1465
(574) 272-5347
(574) 272-8617
Mailing address
611 E DOUGLAS RD STE 200, MISHAWAKA, IN 46545-1465
(574) 272-5347
(574) 272-8617
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Enumeration date
06/22/2022
Last updated
06/28/2022
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