| Michiana Gastroenterology, Inc | |
|
17501 Generations Dr South Bend IN 46635-1589 | |
| (574) 234-0049 | |
| (574) 251-2861 |
| Full Name | Michiana Gastroenterology, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 17501 Generations Dr, South Bend, Indiana |
| Authorized Official Name and Position | Melissa A Walker (ADMINISTRATOR) |
| Authorized Official Contact | 5742340049 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michiana Gastroenterology, Inc 17501 Generations Dr South Bend IN 46635-1589 Ph: (574) 234-0049 | Michiana Gastroenterology, Inc 17501 Generations Dr South Bend IN 46635-1589 Ph: (574) 234-0049 |
| NPI Number | 1821094525 |
|---|---|
| Provider Enumeration Date | 06/27/2005 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 2163529892 |
|---|---|
| Medicare Enrollment ID | O20070515000183 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821094525 | NPI | - | NPPES |
| 100222490A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (Indiana) | Primary |
| Provider Name | Mary J Morey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972500874 PECOS PAC ID: 8628058054 Enrollment ID: I20040724000301 |
| Provider Name | Sonali Shukla |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1003862228 PECOS PAC ID: 2163449000 Enrollment ID: I20051029000074 |
| Provider Name | John G Mathis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427051341 PECOS PAC ID: 7315044047 Enrollment ID: I20101007001427 |
| Provider Name | Oliver D Gilliam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497759765 PECOS PAC ID: 9133226871 Enrollment ID: I20101101000835 |
| Provider Name | Pankaj A Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124022082 PECOS PAC ID: 5496852139 Enrollment ID: I20101101000938 |
| Provider Name | Michael A Manbeck |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649272725 PECOS PAC ID: 2860599503 Enrollment ID: I20101123001271 |
| Provider Name | Lisa A Ostrowski |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1205879913 PECOS PAC ID: 9234303652 Enrollment ID: I20111122000148 |
| Provider Name | Ashley B Obannon |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1629248711 PECOS PAC ID: 3870644982 Enrollment ID: I20120530000165 |
| Provider Name | Thomas R Vanderheyden |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528222387 PECOS PAC ID: 7113183088 Enrollment ID: I20120720000240 |
| Provider Name | Seth F Tatel |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1144433467 PECOS PAC ID: 8426214875 Enrollment ID: I20120730000491 |
| Provider Name | Desiree D Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548502495 PECOS PAC ID: 0446479083 Enrollment ID: I20140915001186 |
| Provider Name | Ravi J Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750607354 PECOS PAC ID: 9133425622 Enrollment ID: I20180730001281 |
| Provider Name | Briana R Weidler-edholm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144882069 PECOS PAC ID: 9032448808 Enrollment ID: I20190904003243 |
| Provider Name | Susan Buford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841969060 PECOS PAC ID: 5890186480 Enrollment ID: I20211215000227 |
Ronald E Grow Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 810 W Indiana Ave, South Bend, IN 46613 Phone: 574-289-5049 Fax: 574-288-0840 | |
Physician Management Services Of Indiana Ii, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 300 S Saint Louis Blvd Ste 204, South Bend, IN 46617 Phone: 888-829-8550 | |
Mcdonald Physical Therapy Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1005 N Hickory Rd, South Bend, IN 46615 Phone: 574-233-5754 Fax: 574-233-7406 | |
South Bend Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 211 N Eddy St, South Bend, IN 46617 Phone: 574-299-2450 Fax: 574-299-2415 | |
Uthman Cavallo, Md, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 53800 Generations Dr, South Bend, IN 46635 Phone: 574-273-3880 Fax: 574-271-0918 | |
Bendix Family Physicians Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1010 N Bendix Dr, South Bend, IN 46628 Phone: 574-245-4980 Fax: 574-245-4981 | |
Beacon Medical Group Ireland Road Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1815 E Ireland Rd, South Bend, IN 46614 Phone: 574-647-1700 Fax: 574-291-3351 |