Individual
JIALIN BAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5215 HOLY CROSS PARKWAY, ANESTHESIA DEPARTMENT, MISHAWAKA, IN 46545-1469
(574) 233-3123
(574) 233-3125
Mailing address
PO BOX 1742, SOUTH BEND, IN 46634-1742
(574) 233-3123
(574) 233-3125
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01061741A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200858550
—
IN
Enumeration date
03/07/2007
Last updated
01/28/2010
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