Individual
MICHAEL J STAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
615 N MICHIGAN ST, 1ST FL HOSPITALIST STE, SOUTH BEND, IN 46601-1033
(574) 647-3050
(574) 647-1094
Mailing address
3245 HEALTH DR., SUITE 100, GRANGER, IN 46530-3245
(547) 647-1840
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
01075143A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300055663
—
IN
Enumeration date
04/04/2011
Last updated
05/01/2023
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