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Memorial Health System, Inc. — NPI 1346290103, South Bend, IN | NPI Central

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NPI 1346290103

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Memorial Health System, Inc.

NPI 1346290103 · Developmental - Behavioral Pediatrics Physician · South Bend, IN

Provider details

NPI number: 1346290103
Entity type: Organization
Primary specialty: Developmental - Behavioral Pediatrics PhysicianAllopathic & Osteopathic Physicians
Organization subpart: No
Authorized official: Jeffrey Costello, Vp-Cfo(574) 647-3549
License: 01060385A (IN)

Specialties & taxonomies

Developmental - Behavioral Pediatrics PhysicianPrimary2080P0006XLicense 01060385A (IN)
Allopathic & Osteopathic Physicians

Practice location

809 N Michigan St

South Bend, IN 46601-1088

Phone: (574) 647-7300

Approximate (ZIP-level) locationGet directions

More IN providers

Mailing address

710 N Niles Ave

South Bend, IN 46617-1924

Other names (DBA / former)

Doing business as: Developmental Pediatrics

Registry dates

Enumerated: 2006-05-11
Last updated: 2016-03-09

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.