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Individual

JOHN F POWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
234 CHAPIN ST STE I, SOUTH BEND, IN 46601-2571
(574) 335-8250
(574) 335-0788
Mailing address
707 CEDAR ST STE 405, SOUTH BEND, IN 46617-2059

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01029534A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100223260
IN
01
1102413754
ANTHEM
IN
Enumeration date
06/15/2006
Last updated
11/10/2023
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