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Contact Information

PEDIATRIC CARDIOLOGY OF MICHIANA, PC
707 N MICHIGAN ST
SUITE 316
SOUTH BEND, IN46601-1067
 Phone: 574-232-3325
 Fax: 574-232-3358
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Cardiology

2080P0202X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for PEDIATRIC CARDIOLOGY OF MICHIANA PC · (Female)

NPI Number 1891816559
Status Active
Credentials
Entity Individual
Enumeration date 04/02/2007
Last updated 06/17/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • IN License # 01034696A
  • IN Medicaid 100475760A
  • Other 4564274 AETNA
  • Other 1761550 CIGNA
  • IN Other 000000330797001 BLUE CROSS BLUE SHIELD IN
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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