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Organization

ALLIED PHYSICIANS OF MICHIANA, LLC

Active
Parent organization
ALLIED PHYSICIANS OF MICHIANA, LLC
Other names
Pediatric Associates of Michiana
Organization subpart
Yes

Provider details

NPI number
Legal business name
ALLIED PHYSICIANS OF MICHIANA, LLC
Authorized official
SHERY ROUSSARIE (CEO)
(574) 251-2100
Entity
Organization

Contact information

Practice address
6301 UNIVERSITY COMMONS, SUITE 320, SOUTH BEND, IN 46635-1571
(574) 271-7337
Mailing address
6301 UNIVERSITY COMMONS, SUITE 230, SOUTH BEND, IN 46635-1571
(574) 251-2100
(574) 251-2151

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200962980K
IN
Enumeration date
02/03/2010
Last updated
08/01/2014
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