Organization
SOUTH BEND IN ENDOSCOPY ASC LLC
Active
Other names
Michiana Endoscopy Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEN P. MCDONALD (CHIEF MANAGER OF LLC)
(615) 665-1283
Entity
Organization
Contact information
Practice address
53830 GENERATIONS DR, SOUTH BEND, IN 46635-1557
(574) 271-0839
Mailing address
53830 GENERATIONS DR, SOUTH BEND, IN 46635-1557
(574) 271-0839
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
12/14/2006
Last updated
01/09/2008
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