Organization
HEARING DIAGNOSTICS CENTER PC
Active
Organization
HEARING DIAGNOSTICS CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID C CRAIG AU.D. (OWNER/PRESIDENT)
(574) 271-0000
Entity
Organization
Contact information
Practice address
2102 IRONWOOD CIR, SOUTH BEND, IN 46635-1864
(574) 271-0000
(574) 273-4325
Mailing address
2102 IRONWOOD CIR, SOUTH BEND, IN 46635-1864
(574) 271-0000
(574) 273-4325
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
58000001A
IN
237600000X
Audiologist-Hearing Aid Fitter
Primary
58000001A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000087118
ANTHEM BCBS AUDIOLOGY
—
01
—
000000201690
HA SUPPLIER
IN
01
—
030310001
ADMINISTAR
IN
05
—
100113470B
—
IN
Enumeration date
12/09/2005
Last updated
11/07/2013
Update your record
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