Michiana Spine, Sports & Occupational Rehab, Pc
LBN: Michiana Spine, Sports & Occupational Rehab, Pc
Michiana Spine, Sports & Occupational Rehab, Pc is an health care organization with primary practice located at 3740 Edison Lakes Pkwy , Mishawaka IN 46545-3474. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as the primary health care specialty.
Michiana Spine, Sports & Occupational Rehab, Pc can be contacted via phone (574) 252-4150, or through Drew, Kevin Gene via phone (574) 252-4150.
Contact Information
Primary practice address
3740 Edison Lakes Pkwy
Mishawaka IN 46545-3474
Phone: (574) 252-4150
Fax: (574) 252-4159
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pain Medicine | 2081P2900X | 01042863 | Indiana |
Profile Details
| NPI number | 1912074659 |
|---|---|
| LBN Legal business name | Michiana Spine, Sports & Occupational Rehab, Pc |
| DBA Doing business as | |
| Authorized official | Drew, Kevin Gene Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 29th, 2006 |
| Last updated | Nov 3rd, 2022 - about 3 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912074659 | NPPES |
| Other | CI5205 | RAILROAD MEDICARE | |
| Other | 129646400 | RAILROAD MEDICARE | |
| MEDICAID | 200216220A | RAILROAD MEDICARE | |
| Other | 25-0A110370 | RAILROAD MEDICARE |
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