Individual
DR. WALTER S. LANGHEINRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 NAVARRE PL, SUITE 6600, SOUTH BEND, IN 46601-1156
(574) 232-7227
(574) 232-2064
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
01042688A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000686406
BCBS BMG NEUROSURGERY SB
IN
05
—
100410110
—
IN
01
—
M400033278
MEDICARE PTAN
IN
01
—
P00933715
RR MEDICARE
IN
Enumeration date
06/29/2006
Last updated
03/30/2021
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