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
Phone: (574) 389-5656
Fax: (574) 523-7891
Website:
Health care specialties
| Specialty | Code | License # | 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 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1831321942 | NPPES |
| Indiana | MEDICAID | 201289950 |
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