Organization
MICHIANA HEMATOLOGY-ONCOLOGY P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAFAT H ANSARI MD (PRESIDENT)
(800) 860-8100
Entity
Organization
Contact information
Practice address
615 N MICHIGAN ST, SOUTH BEND, IN 46601-1033
(800) 860-8100
(574) 237-1341
Mailing address
3975 WILLIAM RICHARDSON DR, SOUTH BEND, IN 46628-9800
(800) 860-8100
(574) 237-1341
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
207VX0201X
Gynecologic Oncology Physician
—
—
2085R0001X
Radiation Oncology Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
10/19/2011
Last updated
03/19/2012
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