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General NPI Number Information
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NPI Number | 1417031907
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Entity Type | Organization
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Legal Business Name | DEL PILAR MEDICAL & URGENT CARE PC
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 03/28/2022
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Provider Practice Location Address
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Address Line | 270 E DAY RD STE 280
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City | MISHAWAKA
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State | IN
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Zip | 46545-3452
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Country | US
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Telephone | 574-271-0268
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Fax | 574-271-0395
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Provider Business Mailing Address
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Address Line | 270 E DAY RD STE 280
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City | MISHAWAKA
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State | IN
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Zip | 46545-3452
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Country | US
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Telephone | 574-271-0268
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Fax | 574-271-0395
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Authorized Official
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Title or Position | CEO
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Name | CANDACE SLUSSER
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Credential |
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Telephone | 574-271-0268
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 02001173
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 02001173
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 02001173A
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License Number State | IN
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