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Organization

CONCORD FAMILY MEDICINE PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROSEMARY PLANERA (PRATICE MANAGER)
(574) 522-1201
Entity
Organization

Contact information

Practice address
25651 COUNTY ROAD 20, ELKHART, IN 46517-2310
(574) 522-1201
Mailing address
25651 COUNTY ROAD 20, ELKHART, IN 46517-2310
(574) 522-1201

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100113550A
IN
Enumeration date
09/26/2006
Last updated
04/22/2008
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