Individual
KATHERINE TIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
211 N EDDY ST, SOUTH BEND, IN 46617-3096
(574) 251-2100
Mailing address
211 N EDDY ST, SOUTH BEND, IN 46617-3096
(574) 251-2100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01087789A
IN
207R00000X
Internal Medicine Physician
125074042
IL
Other
Enumeration date
06/05/2019
Last updated
06/22/2022
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