Individual
DR. JOSEPH J PULVIRENTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
611 E DOUGLAS RD STE 310, MISHAWAKA, IN 46545-1467
(574) 335-6770
(574) 335-0779
Mailing address
707 CEDAR ST STE 405, SOUTH BEND, IN 46617-2059
(574) 335-8707
(574) 335-0741
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
01076163A
IN
207RI0200X
Infectious Disease Physician
036-068071
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-068-071
—
IL
01
—
1100088880
ANTHEM BCBS
IN
05
—
201336900
—
IN
Enumeration date
09/22/2005
Last updated
03/27/2024
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