Individual
KATHERINE OLEARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
611 E DOUGLAS RD STE 408, MISHAWAKA, IN 46545-1468
(574) 335-6440
(574) 335-0806
Mailing address
707 CEDAR ST STE 405, SOUTH BEND, IN 46617-2059
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01089919A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1103118162
ANTHEM BCBS
IN
05
—
300078656
—
IN
Enumeration date
05/10/2017
Last updated
03/27/2024
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