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Organization
ALLIED PHYSICIANS OF MICHIANA, LLC
Active
Organization
ALLIED PHYSICIANS OF MICHIANA, LLC
Active
Parent organization
ALLIED PHYSICIANS OF MICHIANA, LLC
Other names
Michiana Ob/GYN
Organization subpart
Yes
Provider details
NPI number
Legal business name
ALLIED PHYSICIANS OF MICHIANA, LLC
Authorized official
SHERY A. ROUSSARIE (CEO)
(574) 251-2100
Entity
Organization
Contact information
Practice address
515 N LAFAYETTE BLVD, SOUTH BEND, IN 46601-1003
(574) 232-2037
(574) 232-1420
Mailing address
6301 UNIVERSITY COMMONS, SUITE 230, SOUTH BEND, IN 46635-1571
(574) 251-2100
(574) 251-2150
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200962980B
—
IN
Enumeration date
10/06/2009
Last updated
12/29/2017
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