National Provider Identifier Database

PEDIATRIC CARDIOLOGY OF MICHIANA PC
Pediatric Cardiology

A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.


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
* Pediatric Cardiology 2080P0202X

* Indicates primary specialty

NPI Profile & details for PEDIATRIC CARDIOLOGY OF MICHIANA, PC

NPI Number 1891816559
Legal business name
LBN
PEDIATRIC CARDIOLOGY OF MICHIANA, PC
Authorized official STACY SPECKHARD - (OFFICE MANAGER)
Entity Organization
Organization subpart No
Enumeration date 04/02/2007
Last updated 06/17/2008 - About 18 years ago
Sole proprietor1 Not specified
Identifiers
  • IN License #: 01034696A
  • IN Medicaid: 100475760A
  • Other: 4564274 AETNA
  • Other: 1761550 CIGNA
  • IN Other: 000000330797001 BLUE CROSS BLUE SHIELD IN

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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