MICHAEL J STAR NPI 1417246018

NPI Information

NPI: 1417246018
Provider Name: MICHAEL J STAR
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Individual

Specialization: Neurology

PECOS Registration: Yes

Address:
615 N MICHIGAN ST
1ST FL HOSPITALIST STE
SOUTH BEND, IN
ZIP 46601
Phone: (574) 647-3050
Get Directions

Michael J Star is a neurology psychiatry neurology in South Bend, IN. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. Michael J Star NPI is 1417246018. 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:

615 N MICHIGAN ST
1ST FL HOSPITALIST STE
SOUTH BEND, IN
ZIP 46601-033
Phone: (574) 647-3050
Fax: (574) 647-1094

The NPI 1417246018 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 4/4/2011 and was last updated on 5/1/2023.

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	390200000X	Student in an Organized Health Care Education/Training Program				No
2	2084N0400X	Psychiatry & Neurology	Neurology	01075143A	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	300055663	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: 4/28/2024

NPI Synchronization or Removal

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