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Organization

ALLIED PHYSICIANS OF MICHIANA, LLC

Active
Parent organization
ALLIED PHYSICIANS OF MICHIANA, LLC
Other names
General & Vascular Surgery
Organization subpart
Yes

Provider details

NPI number
Legal business name
ALLIED PHYSICIANS OF MICHIANA, LLC
Authorized official
SHERY A. ROUSSARIE (CEO)
(574) 251-2100
Entity
Organization

Contact information

Practice address
621 MEMORIAL DR, SUITE 302, SOUTH BEND, IN 46601-1063
(574) 236-1888
(574) 236-1887
Mailing address
6301 UNIVERSITY COMMONS, SUITE 230, SOUTH BEND, IN 46635-1571
(574) 251-2100
(574) 251-2150

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200962980G
IN
05
200962980H
IN
05
200962980N
IN
05
200962980V
IN
05
200962980W
IN
Enumeration date
10/06/2009
Last updated
01/10/2017
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