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Organization
MICHIANA HEMATOLOGY-ONCOLOGY P C
Active
Organization
MICHIANA HEMATOLOGY-ONCOLOGY P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAFAT H ANSARI M.D. (PRESIDENT)
(574) 234-5123
Entity
Organization
Contact information
Practice address
1668 S US HIGHWAY 421, WESTVILLE, IN 46391-9523
(219) 785-3400
(219) 785-3401
Mailing address
3975 WILLIAM RICHARDSON DR, SOUTH BEND, IN 46628-9800
(574) 234-5123
(574) 968-8488
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
207VX0201X
Gynecologic Oncology Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100389430
—
IN
01
—
1176700001
NSC
IN
Enumeration date
02/05/2007
Last updated
07/03/2013
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