Individual
LINDA A MANSFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1815 E IRELAND RD, SOUTH BEND, IN 46614-2845
(574) 647-1700
(574) 647-7572
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01069249A
IN
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
01069249A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201020040
—
IN
Enumeration date
07/01/2005
Last updated
09/24/2024
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