Individual
DENNIS FITZPATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 ARCADE AVE STE 210, ELKHART, IN 46514-2485
(574) 389-5656
(574) 523-7891
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
(574) 237-6069
Taxonomy
Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
01064493A
IN
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
46012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13580
DEAN
WI
05
—
200986470
—
IN
01
—
236040234
MEDICARE PTAN
IN
05
—
34427300
—
WI
01
—
46012
TOUCHPOINT
WI
01
—
P00058702
RAILROAD MEDICARE
WI
01
—
WI01K9
JOHN DEERE
WI
Enumeration date
11/02/2005
Last updated
07/21/2022
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