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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

NPI # 1891816559
LBN Legal business name PEDIATRIC CARDIOLOGY OF MICHIANA, PC
Authorized official STACY SPECKHARD - (OFFICE MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 04/02/2007
Last updated 06/17/2008 - About 18 years ago
Identifiers
IN License # 01034696A
IN Medicaid 100475760A
Other 4564274 AETNA
Other 1761550 CIGNA
IN Other 000000330797001 BLUE CROSS BLUE SHIELD IN
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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