Individual
DR. AMANDA KATHRINE WILLEMS DUTKIEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
615 N MICHIGAN ST, 5TH FL, SOUTH BEND, IN 46601-1033
(574) 647-7275
(574) 647-3696
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01063419A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200886800
—
IN
Enumeration date
09/05/2007
Last updated
04/28/2023
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