MEDICARE: TRISHA IMHOFF MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	01071185A	IN

General Provider Information

NPI Number	:	1023224466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRISHA IMHOFF MD

Provider Business Mailing Address
First Line	:	226 W US HIGHWAY 20 STE B
Second Line	:
City	:	MIDDLEBURY
State	:	IN
Zip	:	46540-9713
Country	:	US
Telephone Number	:	574-825-2211
Fax Number	:	574-825-2212

Provider Business Practice Location Address
First Line	:	226 W US HIGHWAY 20 STE B
Second Line	:
City	:	MIDDLEBURY
State	:	IN
Zip	:	46540-9713
Country	:	US
Telephone Number	:	574-825-2211
Fax Number	:	574-825-2212

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	01/16/2026

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