Individual
MR. MUKESH GARG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2349 LAKE AVE STE 99, PLYMOUTH, IN 46563
(574) 948-5340
(574) 948-5494
Mailing address
707 CEDAR ST STE 200, SOUTH BEND, IN 46617-2057
(574) 335-8700
(574) 335-0760
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
27641
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300004401
—
IN
01
—
IN1041053
MEDICARE
IN
01
—
P02006928
RAIL ROAD MEDICARE
IN
Enumeration date
03/06/2006
Last updated
06/28/2018
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