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General NPI Number Information
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NPI Number | 1194288860
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Entity Type | Organization
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Legal Business Name | HONOR PHYSICIANS, LLC
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Dates
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Enumeration Date | 04/10/2019
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 3809 N MAIN ST STE 100
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City | MISHAWAKA
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State | IN
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Zip | 46545-3109
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Country | US
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Telephone | 574-520-1700
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Fax | 833-989-0916
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Provider Business Mailing Address
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Address Line | 3809 N MAIN ST STE 200
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City | MISHAWAKA
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State | IN
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Zip | 46545-3109
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Country | US
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Telephone | 574-520-1700
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Fax | 833-989-0916
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | AMY HURT
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Credential | RMA
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Telephone | 574-520-1700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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