Individual
CHRISTOPHER JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
611 E DOUGLAS RD STE 137, MISHAWAKA, IN 46545-1464
(574) 335-6214
(574) 335-6215
Mailing address
707 CEDAR ST STE 405, SOUTH BEND, IN 46617-2059
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
01072993A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01072993A
IN STATE MEDICAL LICENSE
IN
05
—
201110900
—
IN
Enumeration date
06/25/2012
Last updated
11/17/2023
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