# GENERAL & VASCULAR SURGERY PC

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

## Provider details

- **NPI number:** 1740267822
- **Authorized official:** JOHN MCGINLEY (PRACTICE MANGER)
- **Authorized official phone:** (574) 236-1888

## Contact information

- **Practice address:** 621 MEMORIAL DR, SOUTH BEND, IN 46601-1064
- **Practice address phone:** (574) 236-1888
- **Practice address fax:** (574) 236-1887
- **Mailing address:** 621 MEMORIAL DR, SOUTH BEND, IN 46601-1064
- **Mailing address phone:** (574) 236-1888
- **Mailing address fax:** (574) 236-1887

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/29/2005
- **Last updated:** 05/07/2008