Individual
CHARLES HIGGS-COULTHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
611 E DOUGLAS RD STE 406, MISHAWAKA, IN 46545-1468
(574) 335-6580
(574) 335-0796
Mailing address
707 E CEDAR ST, STE 200, SOUTH BEND, IN 46617-2057
(574) 335-8700
(574) 335-0760
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01042925
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100325690A
—
IN
Enumeration date
05/24/2006
Last updated
10/25/2023
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