Individual
ABHISHEK DAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5314 LINCOLNWAY E, MISHAWAKA, IN 46544-4249
(574) 256-9032
(574) 256-9049
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
01077117A
IN
208VP0000X
Pain Medicine Physician
Primary
01077117A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201374760
—
IN
01
—
565800023
MEDICARE PTAN
IN
Enumeration date
08/11/2011
Last updated
05/01/2023
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