Individual
DR. SUSAN R HART-CAVALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
720 CEDAR ST, SUITE 400, SOUTH BEND, IN 46617-2060
(574) 232-3327
(574) 232-3369
Mailing address
53800 GENERATIONS DR, SOUTH BEND, IN 46635-1543
(574) 273-3880
(574) 271-0918
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01055451A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200372550
—
IN
Enumeration date
10/28/2005
Last updated
11/17/2016
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