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Individual

ASAD ANSARI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
100 NAVARRE PL STE 5550, SOUTH BEND, IN 46601-1169
(574) 647-2550
(574) 647-1129
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
(574) 647-1840
(574) 237-6069

Taxonomy

Speciality
Code
Description
License number
State
2080P0208X
Pediatric Infectious Diseases Physician
01065535A
IN
2080P0214X
Pediatric Pulmonology Physician
Primary
01065535A
IN
2080P0214X
Pediatric Pulmonology Physician
4301506067
MI
2080S0012X
Pediatric Sleep Medicine Physician
01065535A
IN
2080S0012X
Pediatric Sleep Medicine Physician
4301506067
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1053387175
MI
05
200928890
IN
Enumeration date
02/28/2006
Last updated
05/04/2023
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