Individual
WILLIAM S KAMANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
53760 GENERATIONS DR, SOUTH BEND, IN 46635-1539
(574) 968-4100
(574) 968-4125
Mailing address
53760 GENERATIONS DR, SOUTH BEND, IN 46635-1539
(574) 968-4100
(574) 968-4125
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
01050428A
IN
207RX0202X
Medical Oncology Physician
01050428A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000341279
BLUE CROSS BLUE SHIELD
—
01
—
20-1373376
FED TAX ID
—
05
—
200234450B
—
IN
Enumeration date
04/13/2006
Last updated
11/22/2023
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