Individual
DR. DAN ALLAN WAXMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
530 N LAFAYETTE BLVD, SOUTH BEND, IN 46601-1004
(574) 234-4176
Mailing address
530 N LAFAYETTE BLVD, SOUTH BEND, IN 46601-1004
(574) 234-4176
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
01047714
IN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
01047714A
IN
Other
Enumeration date
02/28/2007
Last updated
11/10/2020
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