Saint Jude Offices, Llc | |
328 N Michigan St Suite F3 South Bend IN 46601-1244 | |
(262) 527-7410 | |
Not Available |
Full Name | Saint Jude Offices, Llc |
---|---|
Speciality | Internal Medicine |
Location | 328 N Michigan St, South Bend, Indiana |
Authorized Official Name and Position | Sylvana Atallah (M.D.) |
Authorized Official Contact | 2625277410 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Saint Jude Offices, Llc 328 N Michigan St Suite F3 South Bend IN 46601-1244 Ph: (262) 527-7410 | Saint Jude Offices, Llc 328 N Michigan St Suite F3 South Bend IN 46601-1244 Ph: (262) 527-7410 |
NPI Number | 1962862334 |
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Provider Enumeration Date | 02/29/2016 |
Last Update Date | 02/29/2016 |
Medicare PECOS PAC ID | 2163711631 |
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Medicare Enrollment ID | O20160523002438 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962862334 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (Indiana) | Primary |
Provider Name | Sylvana Atallah |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1225235336 PECOS PAC ID: 9234220161 Enrollment ID: I20130419000189 |
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