IndividualActive
Mary Lacoursiere, DO
NPI 1659864387 · Pediatric Critical Care Medicine Physician · South Bend, IN
Provider details
- NPI number
- 1659864387
- Entity type
- Individual
- Primary specialty
- Pediatric Critical Care Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- DO
- Sex
- Female
- Sole proprietor
- No
- License
- 02007852A (IN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
615 N Michigan St 5th Fl
South Bend, IN 46601-1033
Phone: (574) 647-7275
Fax: (574) 647-3696
Approximate (ZIP-level) locationGet directions
Mailing address
3245 Health Dr Ste 100
Granger, IN 46530-1380
Registry dates
- Enumerated
- 2018-06-07
- Last updated
- 2024-08-30
- Certified
- 2024-08-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.