Hubert Fornalik
Obstetrician & Gynecologist Gynecologic Oncologist
5340 Holy Cross Pkwy
Mishawaka
, Indiana 46545-1470
Hubert Fornalik
Obstetrician & Gynecologist Gynecologic Oncologist
5340 Holy Cross Pkwy
Mishawaka
, Indiana 46545-1470
(574) 334-5400
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About
Features
Specialties
- Obstetrician & Gynecologist
- Gynecologic Oncologist
Languages spoken
- English
Location
First Address
- Hubert Fornalik
- 100 E Wayne St Ste 510
- South Bend, IN
- Zip : 46601-2394
- Phone : (574) 334-5400
Second Address
- Hubert Fornalik
- 5340 Holy Cross Pkwy
- Mishawaka, IN
- Zip : 46545-1470
- Phone : (574) 237-1328
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207V00000X | Obstetrician & Gynecologist | 01067752A | IN |
| N | 207V00000X | Obstetrician & Gynecologist | 37108 | IA |
| N | 207V00000X | Obstetrician & Gynecologist | MT181806 | PA |
| Y | 207VX0201X | Gynecologic Oncologist | 01067752A | IN |
National Provider Identifier
| NPI | 1255549812 |
|---|---|
| Provider Name | Hubert Fornalik |
| First Address | South Bend, IN 46601-2394 |
| Second Address | Mishawaka, IN 46545-1470 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 18/05/2007 |
| Last Update Date | 20/05/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 200978000 | (05) | 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.