Mcclain, Debra R

Mcclain, Debra R is an individual health care provider with primary practice located at 310 N Ironwood Dr , South Bend IN 46615-2520. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Mcclain, Debra R can be contacted via phone (574) 968-1222.

Contact Information

Primary practice address
310 N Ironwood Dr South Bend IN 46615-2520
Fax: (574) 968-1223
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01028643 Indiana

Profile Details

NPI number 1487657896
LBN Legal business name Mcclain, Debra R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2005
Last updated Dec 29th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487657896 NPPES
Indiana MEDICAID 100091000A

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