Medical school: LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, ERIE
Graduated: 1999
NPI: 1861599300
Practice Locations (2)
PRIVIA MEDICAL GROUP INDIANA LLC
2115 W LEXINGTON AVE
ELKHART, IN 465141423
5742963955
COMMUNITY CARE NETWORK INC
10240 CALUMET AVE
MUNSTER, IN 463214082
2198368100
Source: CMS National Downloadable File, September 2026.