Individual
DR. CAROL ERDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
615 N MICHIGAN ST, SOUTH BEND, IN 46601-1033
(574) 647-1000
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
071-006805
IL
103G00000X
Clinical Neuropsychologist
20042017A
IN
103G00000X
Clinical Neuropsychologist
Primary
20142017A
IN
103G00000X
Clinical Neuropsychologist
6301013085
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000373437
ANTHEM/BLUE CROSS ID
IN
Enumeration date
10/31/2005
Last updated
03/08/2016
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