Individual
HARI RASAD GOURABATHINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
615 N MICHIGAN ST 5TH FL, SOUTH BEND, IN 46601-1033
(574) 647-7275
(574) 647-3696
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
(574) 237-6069
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
01074968A
IN
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
01074968A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300012715
—
IN
Enumeration date
12/29/2014
Last updated
08/11/2025
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