Dr. Willie Lee Donald
Gynecologist - Maternal & Fetal Medicine
100 Navarre Pl Ste 4410
South Bend
, Indiana 46601-1171
Dr. Willie Lee Donald
Gynecologist - Maternal & Fetal Medicine
100 Navarre Pl Ste 4410
South Bend
, Indiana 46601-1171
(574) 647-1610
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About
Features
Specialties
- Gynecologist - Maternal & Fetal Medicine
Languages spoken
- English
Location
First Address
- Dr. Willie Lee Donald
- 710 N Niles Ave
- South Bend, IN
- Zip : 46617-1924
- Phone : (574) 647-1610
Second Address
- Dr. Willie Lee Donald
- 100 Navarre Pl Ste 4410
- South Bend, IN
- Zip : 46601-1171
- Fax : (574) 647-1655
- Phone : (574) 647-1650
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 01053966A | IN |
National Provider Identifier
| NPI | 1225026669 |
|---|---|
| Provider Name | Dr. Willie Lee Donald |
| First Address | South Bend, IN 46617-1924 |
| Second Address | South Bend, IN 46601-1171 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 10/10/2005 |
| Last Update Date | 30/11/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000000195250 | BCBS BMG MFM (01) | IN |
| 000000857598 | BCBS BMG E BLAIR WARNER (01) | IN |
| 200318520 | (05) | IN |
| D14882 | (02) | IN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.