Unknown Individual – Family Medicine Physician, NPI 1013907419
Family Medicine Physician
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
211, North Eddy Street, South Bend, Saint Joseph County, Indiana, 46617, United States
SOUTH BEND, IN 466173096
Phone: (574) 237-9340
Fax: (574) 239-1474
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 46617)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IN | |
| - | IN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | IN | |
| - | IN | |
| Family Practice | KY | |
| Family Practice | IN | |
| O P H T H A L M O L O G Y | IN | |
| Physician Assistant | IN | |
| Family Practice | IN | |
| Physician Assistant | IN |
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