Organization
ALLIED PHYSICIANS OF MICHIANA, LLC
Active
Parent organization
ALLIED PHYSICIANS OF MICHIANA, LLC
Other names
Allied ENT Specialty Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
ALLIED PHYSICIANS OF MICHIANA, LLC
Authorized official
SHERY A. ROUSSARIE (CEO)
(574) 251-2100
Entity
Organization
Contact information
Practice address
6301 UNIVERSITY COMMONS, SUITE 360, SOUTH BEND, IN 46635-1571
(574) 232-4800
(574) 280-4810
Mailing address
6301 UNIVERSITY COMMONS, SUITE 230, SOUTH BEND, IN 46635-1571
(574) 251-2100
(574) 251-2151
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200962980F
—
IN
05
—
200962980P
—
IN
Enumeration date
10/08/2009
Last updated
10/02/2015
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