Organization
MICHIANA GASTROENTEROLOGY, INC
Active
Organization
MICHIANA GASTROENTEROLOGY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MELISSA A WALKER (ADMINISTRATOR)
(574) 234-0049
Entity
Organization
Contact information
Practice address
17501 GENERATIONS DR, SOUTH BEND, IN 46635-1589
(574) 234-0049
(574) 251-2861
Mailing address
17501 GENERATIONS DR, SOUTH BEND, IN 46635-1589
(574) 234-0049
(574) 251-2861
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100222490A
—
IN
Enumeration date
06/27/2005
Last updated
07/21/2022
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