Medical school: UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
Graduated: 1999
NPI: 1255438644
Practice Locations (5)
THE SOUTH BEND CLINIC LLC
211 N EDDY ST
SOUTH BEND, IN 466172808
5742348161
LEGACY PATH LLC
3355 DOUGLAS RD
SOUTH BEND, IN 466351779
5742344176
SOUTH BEND MEDICAL FOUNDATION INC
530 N LAFAYETTE BLVD
SOUTH BEND, IN 466011004
5742344176
SOUTH BEND MEDICAL FOUNDATION INC
1521 GULL RD
KALAMAZOO, MI 490481640
2692667231
LEGACY PATH LLC
1521 GULL RD
KALAMAZOO, MI 490481640
2692267231
Source: CMS National Downloadable File, September 2026.