Organization
ALLIED FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAUREEN ZIBOH M.D. (OWNER/PRESIDENT)
(574) 968-2500
Entity
Organization
Contact information
Practice address
314 W CATALPA DR, SUITE A, MISHAWAKA, IN 46545-3194
(574) 255-1522
(574) 255-1540
Mailing address
PO BOX 6219, SOUTH BEND, IN 46660-6219
(574) 255-1522
(574) 255-1540
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1184651499
ANTHEM BLUE CROSS BLUE SHIELD
IN
05
—
200542230B
—
IN
Enumeration date
06/26/2006
Last updated
09/30/2011
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