Primary Care Partners Of South Bend | |
300 S Saint Louis Blvd Ste 204 South Bend IN 46617-3044 | |
(574) 251-1200 | |
(574) 251-1230 |
Full Name | Primary Care Partners Of South Bend |
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Speciality | Family Medicine |
Location | 300 S Saint Louis Blvd Ste 204, South Bend, Indiana |
Authorized Official Name and Position | Brandon Zabukovic (MANAGING MEMBER) |
Authorized Official Contact | 5742749425 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Primary Care Partners Of South Bend 300 S Saint Louis Blvd Ste 204 South Bend IN 46617-3044 Ph: (574) 251-1200 | Primary Care Partners Of South Bend 300 S Saint Louis Blvd Ste 204 South Bend IN 46617-3044 Ph: (574) 251-1200 |
NPI Number | 1497399927 |
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Provider Enumeration Date | 10/28/2019 |
Last Update Date | 07/10/2020 |
Medicare PECOS PAC ID | 7810319712 |
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Medicare Enrollment ID | O20200623001632 |
Identifier | Type | State | Issuer |
---|---|---|---|
1497399927 | NPI | - | NPPES |
Provider Name | Brandon William Zabukovic |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1710962915 PECOS PAC ID: 6204749344 Enrollment ID: I20031106000119 |
Provider Name | Christine E Coulter |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144479460 PECOS PAC ID: 2567478175 Enrollment ID: I20081212000511 |
Provider Name | Mary Hope Griffin |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1659402220 PECOS PAC ID: 2668480690 Enrollment ID: I20100126000505 |
Provider Name | Rebekah R Kottkamp |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881018729 PECOS PAC ID: 4587897244 Enrollment ID: I20140502001437 |
Provider Name | Ashley Brunt |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1932678679 PECOS PAC ID: 9436488319 Enrollment ID: I20190903002194 |
Provider Name | Bailey Swan |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1326627258 PECOS PAC ID: 2668872714 Enrollment ID: I20240612001528 |
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