| Dr Holly L Hake-harris, MD | |
|
211 N Eddy St, South Bend, IN 46617-2808 | |
| (574) 237-9231 | |
| (574) 237-9208 |
| Full Name | Dr Holly L Hake-harris |
|---|---|
| Gender | Female |
| Speciality | Dermatology |
| Experience | 43 Years |
| Location | 211 N Eddy St, South Bend, Indiana |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538159207 | NPI | - | NPPES |
| 100090170 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207N00000X | Dermatology | 01035334A (Indiana) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| The South Bend Clinic Llc | 3779577937 | 160 |
| Entity Name | The South Bend Clinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073680419 PECOS PAC ID: 3779577937 Enrollment ID: O20040412000439 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Holly L Hake-harris, MD 211 N Eddy St, South Bend, IN 46617-2808 Ph: (574) 237-9231 | Dr Holly L Hake-harris, MD 211 N Eddy St, South Bend, IN 46617-2808 Ph: (574) 237-9231 |
Linda Higginbotham, MD Dermatology Medicare: Not Enrolled in Medicare Practice Location: 211 N Eddy St, South Bend, IN 46617 Phone: 574-237-9231 Fax: 574-204-6355 | |
Dr. Luiz C Pantalena Filho, MD, PHD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 4322 S Lafayette Blvd, South Bend, IN 46614 Phone: 574-391-1111 Fax: 574-859-5040 | |
Kathleen Kelley, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 4322 S Lafayette Blvd, South Bend, IN 46614 Phone: 574-391-1111 Fax: 574-859-5040 | |
Dr. Cynthia E Mayfield, MD Dermatology Medicare: Medicare Enrolled Practice Location: 2102 E Inwood Rd, South Bend, IN 46614 Phone: 574-299-2400 Fax: 574-299-2410 | |
Dr. Mary K Harder, MD Dermatology Medicare: Not Enrolled in Medicare Practice Location: 211 N Eddy St, South Bend, IN 46617 Phone: 574-237-9231 Fax: 574-237-9208 |