# ALLIED PHYSICIANS OF MICHIANA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ALLIED PHYSICIANS OF MICHIANA, LLC
- **Other names:** Michiana Ob/GYN
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1689909848
- **Legal business name:** ALLIED PHYSICIANS OF MICHIANA, LLC
- **Authorized official:** SHERY A. ROUSSARIE (CEO)
- **Authorized official phone:** (574) 251-2100

## Contact information

- **Practice address:** 515 N LAFAYETTE BLVD, SOUTH BEND, IN 46601-1003
- **Practice address phone:** (574) 232-2037
- **Practice address fax:** (574) 232-1420
- **Mailing address:** 6301 UNIVERSITY COMMONS, SUITE 230, SOUTH BEND, IN 46635-1571
- **Mailing address phone:** (574) 251-2100
- **Mailing address fax:** (574) 251-2150

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/06/2009
- **Last updated:** 12/29/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200962980B | — | IN |