Organization
PRIVIA MEDICAL GROUP INDIANA, LLC
Active
Other names
Primary Care at Mishawaka, Narcysia Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN R BOYER (CHIEF EXECUTIVE OFFICER)
(574) 296-3200
Entity
Organization
Contact information
Practice address
410 PARK PL STE A, MISHAWAKA, IN 46545-3557
(574) 252-0667
(574) 807-8845
Mailing address
410 PARK PL, SUITE A, MISHAWAKA, IN 46545-3557
(574) 252-0667
(574) 807-8845
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100466600
—
IN
Enumeration date
09/15/2006
Last updated
05/12/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us