| Patrick E Southe, MD | |
|
6913 N Main St, Granger, IN 46530-8039 | |
| (574) 647-1550 | |
| (574) 243-4306 |
| Full Name | Patrick E Southe |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 6913 N Main St, Granger, Indiana |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396764270 | NPI | - | NPPES |
| 000000782901 | Other | IN | ANTHEM |
| 01042581B | Other | IN | CSR |
| 01042581A | Other | IN | INDIANA LICENSE |
| 100385740 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 01042581A (Indiana) | Primary |
| 207Q00000X | Family Medicine | 01042581A (Indiana) | Secondary |
| Mailing Address | Practice Location Address |
|---|---|
| Patrick E Southe, MD 710 N Niles Ave, South Bend, IN 46617-1924 Ph: (574) 647-1610 | Patrick E Southe, MD 6913 N Main St, Granger, IN 46530-8039 Ph: (574) 647-1550 |
Wade Wenger, Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 6913 N Main St, Granger, IN 46530 Phone: 574-647-1550 | |
Dennis Patrick Erdman, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 6913 N Main St, Granger, IN 46530 Phone: 574-647-1500 Fax: 574-243-4306 |