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Organization

SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAMES P SIERADZKI M.D. (PRESIDENT)
(574) 247-9441
Entity
Organization

Contact information

Practice address
53880 CARMICHAEL DR, SOUTH BEND, IN 46635-1567
(574) 247-9441
(574) 247-9442
Mailing address
53880 CARMICHAEL DR, SOUTH BEND, IN 46635-1567
(574) 247-9441
(574) 247-9442

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
50000460A
IN
207XS0106X
Orthopaedic Hand Surgery Physician
50000460A
IN
207XS0117X
Orthopaedic Surgery of the Spine Physician
50000460A
IN
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
50000460A
IN
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
50000460A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100220150A
IN
Enumeration date
05/09/2006
Last updated
05/11/2017
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