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MEMORIAL HEALTH SYSTEM INC. NPI 1346290103


NPI Information

NPI: 1346290103
Provider Name: MEMORIAL HEALTH SYSTEM, INC.

Doing Business As: DEVELOPMENTAL PEDIATRICS

Classification: Pediatrics - 2080P0006X
Entity Type: Organization

Specialization: Developmental - Behavioral Pediatrics

Address:
809 N MICHIGAN ST
SOUTH BEND, IN
ZIP 46601
Phone: (574) 647-7300
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MEMORIAL HEALTH SYSTEM, INC. is a developmental - behavioral pediatrics pediatrics in South Bend, IN. The provider is a developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development. MEMORIAL HEALTH SYSTEM, INC. NPI is 1346290103. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Developmental Pediatrics.

The provider's business location address is:

809 N MICHIGAN ST
SOUTH BEND, IN
ZIP 46601-088
Phone: (574) 647-7300

The provider's authorized official is Jeffrey Costello .
The authorized official title is Vp-cfo and has the following contact phone number (574) 647-3549.

The enumeration date for this NPI number is 5/11/2006 and was last updated on 3/9/2016.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12080P0006XPediatricsDevelopmental - Behavioral Pediatrics01060385AINDIANAYes

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: 4/28/2024

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