DR. JON ANDREW SHULL M.D. NPI 1013948348

NPI Information

NPI: 1013948348
Provider Name: DR. JON ANDREW SHULL, M.D.
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Address:
1708 HIGH ST
SOUTH BEND, IN
ZIP 46613
Phone: (574) 647-1400
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DR. Jon Andrew Shull, M.D. is a family medicine in South Bend, IN. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Jon Andrew Shull, M.D. NPI is 1013948348. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1708 HIGH ST
SOUTH BEND, IN
ZIP 46613-633
Phone: (574) 647-1400
Fax: (574) 237-6663

The enumeration date for this NPI number is 7/5/2006 and was last updated on 10/28/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		01064025A	INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	200872740	MEDICAID	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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