Randal D Bladel, MD | |
416 E Monroe Street, Suite 200, South Bend, IN 46601-2360 | |
(574) 232-8119 | |
(574) 288-0235 |
Full Name | Randal D Bladel |
---|---|
Gender | Male |
Speciality | Anesthesiology |
Location | 416 E Monroe Street, South Bend, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1588641336 | NPI | - | NPPES |
100375310 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207L00000X | Anesthesiology | 01042383 (Indiana) | Primary |
Entity Name | Denali Anesthesia Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1508854712 PECOS PAC ID: 2567455678 Enrollment ID: O20040405001747 |
Mailing Address | Practice Location Address |
---|---|
Randal D Bladel, MD 416 E Monroe Street, Suite 200, South Bend, IN 46601-2360 Ph: (574) 232-8119 | Randal D Bladel, MD 416 E Monroe Street, Suite 200, South Bend, IN 46601-2360 Ph: (574) 232-8119 |
Dr. Fahimulla Z Shariff, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 416 E Monroe St, Suite 200, South Bend, IN 46601 Phone: 574-232-8119 Fax: 574-288-0235 | |
Dr. Bryan R Wipperman, M.D. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 416 E Monroe St, Suite 200, South Bend, IN 46601 Phone: 574-232-8119 Fax: 574-288-0235 | |
Dr. Ike Van Trinh, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 416 E Monroe St, Suite 200, South Bend, IN 46601 Phone: 574-232-8119 Fax: 574-288-0235 | |
Shane Michael Ditty, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 416 E Monroe St, Ste. 200, South Bend, IN 46601 Phone: 574-232-8119 Fax: 574-288-0235 | |
Dr. Ryan R. Sorrell, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 416 E Monroe St, Suite 200, South Bend, IN 46601 Phone: 574-232-8119 Fax: 574-288-0235 | |
Daniel M Cooke, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 416 E Monroe St, Suite 200, South Bend, IN 46601 Phone: 574-232-8119 Fax: 574-288-0235 | |
Theresa R. Cruthird, M.D. Anesthesiology Medicare: Medicare Enrolled Practice Location: 121 S Saint Louis Blvd, South Bend, IN 46617 Phone: 574-233-3123 Fax: 574-233-3125 |