Organization
ALLIED PHYSICIANS OF MICHIANA, LLC
Active
Parent organization
ALLIED PHYSICIANS OF MICHIANA, LLC
Other names
Allied Bone and Joint
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
2349 LAKE AVE, SUITE 201, PLYMOUTH, IN 46563-7835
(574) 540-2500
(574) 540-2570
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
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201236170
—
IN
01
—
4108460008
MEDICARE PTAN
IN
Enumeration date
10/02/2014
Last updated
12/29/2014
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