Organization
SOUTH BEND PSYCHIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MALLIKARJUN PATTA MD (AUTHORIZED OFFICIAL)
(574) 303-5375
Entity
Organization
Contact information
Practice address
1800 N OAK DR, PLYMOUTH, IN 46563-3406
(574) 303-5375
Mailing address
11106 BIRCH LAKE DR, GRANGER, IN 46530-6032
(574) 303-5375
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
10/19/2009
Last updated
09/15/2021
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