Organization
STAR PSYCHIATRIC SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KHUTB UDDIN M.D.PHD. (OWNER)
(574) 243-0112
Entity
Organization
Contact information
Practice address
239 N DIXIE WAY, SOUTH BEND, IN 46637-3309
(574) 243-0112
Mailing address
239 N DIXIE WAY, SOUTH BEND, IN 46637-3309
(574) 243-0112
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
10/05/2012
Last updated
10/26/2012
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