Medical school: INDIANA UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1989
NPI: 1982703419
Practice Locations (5)
SOUTH BEND MEDICAL FOUNDATION INC
3355 DOUGLAS RD
SOUTH BEND, IN 466351779
5742344176
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.