Individual
DR. ELISA BELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
403 E MADISON ST, SOUTH BEND, IN 46617-2322
(574) 283-1234
(574) 537-2652
Mailing address
PO BOX 809, GOSHEN, IN 46527-0809
(574) 533-1234
(537) 537-2652
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
036084180
IL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
01040902A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036084180
—
IL
Enumeration date
01/09/2007
Last updated
08/16/2011
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