Organization
ELITE EMERGENCY PHYSICIANS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID E VANRYN MD (PRESIDENT)
(574) 523-3161
Entity
Organization
Contact information
Practice address
600 EAST BLVD, ELKHART, IN 46514-2483
(574) 271-2558
Mailing address
600 EAST BLVD, ELKHART, IN 46514-2483
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100112790
—
IN
05
—
100114310
—
IN
Enumeration date
05/26/2006
Last updated
09/04/2019
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