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Individual

BRENDAN THOMAS DURR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
610 N MICHIGAN ST STE 400, SOUTH BEND, IN 46601-1081
(574) 647-8120
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
02006354A
IN
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300050074
IN
Enumeration date
03/26/2015
Last updated
07/09/2021
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