Graduated: 2009
NPI: 1952534943
Practice Locations (2)
PRIVIA MEDICAL GROUP INDIANA LLC
2115 W LEXINGTON AVE
ELKHART, IN 465141423
5742963955
MEDSTAT LLC
1500 PROVIDENT DR, SUITE A
WARSAW, IN 465803297
5743727637
Source: CMS National Downloadable File, September 2026.