Individual
PATRICK LEE STUDTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
615 N. MICHIGAN STREET, EMERGENCY DEPARTMENT, SOUTH BEND, IN 46601-1033
(574) 647-7459
(574) 647-3658
Mailing address
615 N MICHIGAN ST, SOUTH BEND, IN 46601-1087
(574) 647-7459
(574) 647-3658
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
02005200A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300008298
—
IN
01
—
941030015
MEDICARE PTAN
IN
Enumeration date
05/19/2015
Last updated
07/31/2018
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