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Contact Information

ORTHOPEDIC AND SPORTS MEDICINE CENTER OF NORTHERN INDIANA, INC
2310 CALIFORNIA RD STE A
ELKHART, IN46514-1228
 Phone: 574-264-0791
 Fax: 574-262-9650
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
 

Foot and Ankle Surgery

207XX0004X 02 Physician/General Surgery
 

Hand Surgery

207XS0106X 02 Physician/General Surgery
 

Pain Medicine

207LP2900X 05 Physician/Anesthesiology
 

Sports Medicine

2081S0010X 25 Physician/Physical Medicine and Rehabilitation
Indicates primary specialty

NPI Profile & details for ORTHOPEDIC AND SPORTS MEDICINE CENTER OF NORTHERN INDIANA INC · (Female)

NPI # 1710085253
Status Active
Credentials
Entity Individual
Enumeration date 09/20/2006
Last updated 02/05/2019 - About 7 years ago
Sole proprietor 1 Not specified
Identifiers
  • IN License # 50000745A
  • IN Medicaid 100111780
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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