Privia Medical Group Indiana, LLC
Privia Medical Group Indiana, LLC is a Multi-Specialty Clinic/Center in Mishawaka, Indiana. Registered with an NPI since 2008.
- In the registry since
- 2008
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
410 Park Pl Ste BMishawaka, IN 46545-3557
Phone: (574) 855-5800
Fax: (574) 855-5805
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Multi-Specialty Clinic/Center (primary) | Taxonomy 261QM1300X |
|---|
Record details
| NPI number | 1235303165 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Timothy Porsche — Managing Partner · (574) 296-3200 |
| Other names | Edison Lakes Urology; Primary Care At Mishawaka |
| NPI enumerated | April 22, 2008 |
| Last updated in NPPES | May 12, 2025 |
| Certification date | May 12, 2025 |
| Mailing address | Po Box 2968, Elkhart, IN 46515-2968 |
Other providers in Mishawaka
-
Delaney Fullenkamp
1316 W Dragoon Trl, Mishawaka, IN 46544-4713 · (219) 608-2190
-
Saint Joseph Community Hospital of Mishawaka
201 Lincoln Way W, Mishawaka, IN 46544-1905 · (574) 252-3699