Individual
BENJAMIN P. YOURCHOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
506 MICHIGAN STREET, WALKERTON, IN 46574-1116
(574) 335-5200
(574) 335-0858
Mailing address
707 CEDAR ST STE 405, SOUTH BEND, IN 46617-2059
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01082203A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102538181
ANTHEM
IN
05
—
201376710
—
IN
Enumeration date
06/03/2016
Last updated
11/09/2023
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