# SOUTH BEND MEDICAL FOUNDATION, INC

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

## Provider details

- **NPI number:** 1649241084
- **Authorized official:** TERRY PIPP (CFO)
- **Authorized official phone:** (574) 234-7176

## Contact information

- **Practice address:** 3355 DOUGLAS RD, SOUTH BEND, IN 46635-1779
- **Practice address phone:** (574) 234-4176
- **Mailing address:** PO BOX 11957, FORT WAYNE, IN 46862-1957
- **Mailing address phone:** (800) 288-8325
- **Mailing address fax:** (419) 866-5453

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | NULL | Yes |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | — | Yes |
| 291U00000X | Clinical Medical Laboratory | — | NULL | — |

## Other

- **Enumeration date:** 02/01/2006
- **Last updated:** 07/16/2026