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Individual

ROBERT J AUSTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
615 N MICHIGAN ST, SOUTH BEND, IN 46601-1033
(574) 647-1650
(574) 647-1655
Mailing address
1428 FOREST DR, PORTAGE, MI 49002-6320
(269) 873-8955
(269) 324-2476

Taxonomy

Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
01053969A
IN
207VM0101X
Maternal & Fetal Medicine Physician
20122
WI
207VM0101X
Maternal & Fetal Medicine Physician
Primary
4301033245
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1558407189
GROUP NPI
MI
01
1604114351
BCBS
MI
05
4656419
MI
05
6062403
MI
Enumeration date
04/07/2006
Last updated
07/06/2022
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