OrganizationActive
Privia Medical Group Indiana, LLC
NPI 1851497945 · Multi-Specialty Clinic/Center · Mishawaka, IN
Provider details
- NPI number
- 1851497945
- Entity type
- Organization
- Primary specialty
- Multi-Specialty Clinic/CenterAmbulatory Health Care Facilities
- Authorized official
- Kevin Boyer, Chief Executive Officer
Practice location
410 Park Pl Ste a
Mishawaka, IN 46545-3557
Phone: (574) 252-0667
Fax: (574) 807-8845
Mailing address
410 Park Pl
Mishawaka, IN 46545-3557
Registry dates
- Enumerated
- 2006-09-15
- Last updated
- 2025-05-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.