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Dr. Greg M Mielke, MD
Specialist in Goshen, Indiana
NPI 1366484099

Greg M Mielke is a Specialist based in Fort Wayne, IN. Greg M Mielke practices in Goshen, IN and has the professional credentials of MD. The NPI Number for Greg M Mielke is 1366484099 and holds a License No. 01034860A (Indiana).

The current practice location address for Greg M Mielke is 1111 Lighthouse Ln, Goshen, IN and can be reached out via phone at 574-533-0348 and via fax at 574-533-0277.

Location: 1111 Lighthouse Ln, Goshen, IN, 46845-1712
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1366484099
Provider Name
Greg M Mielke
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1111 Lighthouse Ln, Goshen, IN, 46845-1712
Phone Number
574-533-0348
Fax Number
574-533-0277
Provider Enumeration Date
06/10/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100113720 05 IN
institution
Provider Business Practice Location Address Details
Address
1111 Lighthouse Ln
City
Goshen
State
Indiana
Zip
46526-3824
Phone Number
574-533-0348
Fax Number
574-533-0277
person
Provider Business Mailing Address Details
Address
1111 Lighthouse Ln
City
Goshen
State
Indiana
Zip
46526-3824
Phone Number
574-533-0348
Fax Number
574-533-0277
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
01034860A (Indiana)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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