| Micah Spencer, | |
|
611 E Douglas Rd Ste 407, Mishawaka, IN 46545 | |
| (574) 335-6500 | |
| Not Available |
| Full Name | Micah Spencer |
|---|---|
| Gender | Male |
| Speciality | Podiatry |
| Experience | 7 Years |
| Location | 611 E Douglas Rd Ste 407, Mishawaka, Indiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558850164 | NPI | - | NPPES |
| 300014870 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | 99086926A (Indiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Saint Joseph Regional Medical Center | Mishawaka, IN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| The South Bend Clinic Llc | 3779577937 | 160 |
| Provider Name | The South Bend Clinic Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1073680419 PECOS PAC ID: 3779577937 Enrollment ID: O20040412000439 |
| Mailing Address | Practice Location Address |
|---|---|
| Micah Spencer, 211 N Eddy St, South Bend, IN 46617-2808 Ph: (574) 299-2450 | Micah Spencer, 611 E Douglas Rd Ste 407, Mishawaka, IN 46545 Ph: (574) 335-6500 |
Dr N W Worden Pc Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 2206 Lincolnway E, Mishawaka, IN 46544 Phone: 574-258-5060 Fax: 574-258-5076 | |
Michael Salcedo Dpm Podiatrist Medicare: Medicare Enrolled Practice Location: 3665 Park Pl W, Suite 200, Mishawaka, IN 46545 Phone: 574-271-1030 Fax: 574-271-1032 | |
Cassandra Papak, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 611 E Douglas Rd, Ste 406, Mishawaka, IN 46545 Phone: 574-335-6500 Fax: 574-335-0772 | |
Dr. N W Worden, DPM Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 2206 Lincoln Way E, Mishawaka, IN 46544 Phone: 574-258-5060 Fax: 574-258-5076 | |
Michael Salcedo, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 3665 Park Pl W, Suite 200, Mishawaka, IN 46545 Phone: 574-271-1030 Fax: 574-271-1032 | |
Jason R Grove, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 611 E Douglas Rd Ste 101, Mishawaka, IN 46545 Phone: 574-335-6800 Fax: 574-335-0772 |