Pradny, Matous

Pradny, Matous is an individual health care provider with primary practice located at 5215 Holy Cross Parkway , Mishawaka IN 46545-1469. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Pradny, Matous can be contacted via phone (574) 237-7111.

Contact Information

Primary practice address
5215 Holy Cross Parkway Mishawaka IN 46545-1469
Phone: (574) 237-7111
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 4301088348 Michigan
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 01066616A Indiana
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X 4301088348 Michigan

Profile Details

NPI number 1255535779
LBN Legal business name Pradny, Matous
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 11th, 2007
Last updated Dec 17th, 2009 - about 15 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 1255535779 NPPES
Indiana Other 000000626995 BCBS

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