Kurtis Dejong
Emergency Physician Emergency Medical Services
5215 Holy Cross Pkwy Emergency Department
Mishawaka
, Indiana 46545-1469
Kurtis Dejong
Emergency Physician Emergency Medical Services
5215 Holy Cross Pkwy Emergency Department
Mishawaka
, Indiana 46545-1469
(574) 335-5000
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About
Features
Specialties
- Emergency Physician
- Emergency Medical Services
Languages spoken
- English
Location
First Address
- Kurtis Dejong
- 5215 Holy Cross Pkwy Emergency Department
- Mishawaka, IN
- Zip : 46545-1469
- Phone : (574) 335-5000
Second Address
- Kurtis Dejong
- 5215 Holy Cross Pkwy Emergency Department
- Mishawaka, IN
- Zip : 46545-1469
- Phone : (574) 335-5000
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What type of doctor is Kurtis Dejong
In what state does Kurtis Dejong practice in?
Where is Kurtis Dejong ’s practice located?
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Is Kurtis Dejong a sole practitioner?
Is Kurtis Dejong accepting new patients?
What languages does Kurtis Dejong speak?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207P00000X | Emergency Physician | 01039621 | IN |
| N | 207PE0004X | Emergency Medical Services | 01039621 | IN |
National Provider Identifier
| NPI | 1184680159 |
|---|---|
| Provider Name | Kurtis Dejong |
| First Address | Mishawaka, IN 46545-1469 |
| Second Address | Mishawaka, IN 46545-1469 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 26/04/2006 |
| Last Update Date | 16/12/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000000190295 | ANTHEM (01) | IN |
| 104943838 | (05) | MI |
| 200022520 | (05) | IN |
| 930102831 | RAIL ROAD MEDICARE (01) | IN |
| E52700 | (02) | IN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.