Healthcare Provider Details
I. General information
NPI: 1871987735
Provider Name (Legal Business Name): JAMIE MARIE O'REAR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/27/2015
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
500 ARCADE AVE STE 320
ELKHART IN
46514-2477
US
IV. Provider business mailing address
3245 HEALTH DR STE 100
GRANGER IN
46530-1380
US
V. Phone/Fax
- Phone: 574-523-7900
- Fax: 574-523-7909
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 01084265A |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: