Heredia Vintimilla, Diego Jose

Heredia Vintimilla, Diego Jose is an individual health care provider with primary practice located at 500 Arcade Ave Ste 210 , Elkhart IN 46514-2485. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Critical Care Medicine. Allopathic & Osteopathic Physicians / Critical Care Medicine is his primary health care specialty. Heredia Vintimilla, Diego Jose can be contacted via phone (574) 389-5656.

Contact Information

Primary practice address
500 Arcade Ave Ste 210 Elkhart IN 46514-2485
Fax: (574) 523-7891
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 01074507A Indiana
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 01074507A Indiana
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 01074507A Indiana

Profile Details

NPI number 1831321942
LBN Legal business name Heredia Vintimilla, Diego Jose
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2009
Last updated Feb 19th, 2024 - about 9 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831321942 NPPES
Indiana MEDICAID 201289950

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