Organization
UROLOGY ASSOCIATES OF SOUTH BEND, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ARTHUR PHILIP DEPAUW M.D. (PRESIDENT)
(574) 234-4100
Entity
Organization
Contact information
Practice address
707 CEDAR ST, SUITE #450, SOUTH BEND, IN 46617-2054
(574) 234-4100
Mailing address
707 CEDAR ST, SUITE #450, SOUTH BEND, IN 46617-2054
(574) 234-4100
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0323020001
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0323020001
DMERC LICENSE
IN
Enumeration date
04/19/2006
Last updated
08/22/2020
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