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Organization
SOUTH BEND MEDICAL FOUNDATION, INC
Active
Organization
SOUTH BEND MEDICAL FOUNDATION, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY PIPP (CFO)
(574) 234-7176
Entity
Organization
Contact information
Practice address
3355 DOUGLAS RD, SOUTH BEND, IN 46635-1779
(574) 234-4176
Mailing address
PO BOX 11957, FORT WAYNE, IN 46862-1957
(800) 288-8325
(419) 866-5453
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
NULL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
NULL
Other
Enumeration date
02/01/2006
Last updated
07/16/2026
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