Kricheff, Mark Lawrence

Kricheff, Mark Lawrence is an individual health care provider with primary practice located at 5215 Holy Cross Pkwy Emergency Department, Mishawaka IN 46545-1469. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Kricheff, Mark Lawrence can be contacted via phone (574) 335-5000.

Contact Information

Primary practice address
5215 Holy Cross Pkwy Emergency Department Mishawaka IN 46545-1469
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 01058250 Indiana

Profile Details

NPI number 1265416721
LBN Legal business name Kricheff, Mark Lawrence
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2005
Last updated Dec 16th, 2011 - about 14 years 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 1265416721 NPPES
Indiana Other 000000381040 ANTHEM
Indiana MEDICAID 104838108 ANTHEM
Indiana MEDICAID 200464420 ANTHEM
Indiana Other P00277831 ANTHEM

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