Individual
THOMAS LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4440 PORTAGE AVE, SOUTH BEND, IN 46628-9570
(574) 204-6200
(574) 239-1520
Mailing address
4440 PORTAGE AVE, SOUTH BEND, IN 46628-9570
(574) 204-6200
(574) 239-1520
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01075173A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201112870
—
IN
Enumeration date
06/26/2012
Last updated
09/09/2015
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us