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Individual

DR. KEVIN JEREMY MCAWARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
111 W JEFFERSON BLVD, STE. 100, SOUTH BEND, IN 46601-1994
(574) 647-1669
(574) 239-6461
Mailing address
3355 DOUGLAS RD, STE. 300, SOUTH BEND, IN 46635-1781

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01058339A
IN
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
01058339A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200464680
IN
Enumeration date
11/02/2005
Last updated
09/25/2008
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