Individual
DR. KENNETH EUGENE ELEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
714 N MICHIGAN ST, SOUTH BEND, IN 46601-1035
(574) 647-7477
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
(574) 647-2129
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01031577A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100223720
—
IN
Enumeration date
10/11/2005
Last updated
08/22/2024
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