# SOUTH SIDE FOOT AND ANKLE CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295066546
- **Authorized official:** DR. JULIE A WIEGER DPM (OWNER)
- **Authorized official phone:** (574) 231-1960

## Contact information

- **Practice address:** 3506 S MICHIGAN ST, SOUTH BEND, IN 46614-1728
- **Practice address phone:** (574) 231-1960
- **Practice address fax:** (574) 231-1961
- **Mailing address:** 3506 S MICHIGAN ST, SOUTH BEND, IN 46614-1728
- **Mailing address phone:** (574) 231-1960
- **Mailing address fax:** (574) 231-1961

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 07000810A | IN | Yes |

## Other

- **Enumeration date:** 01/27/2010
- **Last updated:** 01/27/2010