Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 37175 | IA |
N | 207V00000X | Obstetrician & Gynecologist | 4301095680 | MI |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 01083500A | IN |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 4301095680 | MI |
NPI | 1326258740 |
---|---|
Provider Name | Lori Jean Day |
First Address | South Bend, IN 46601-1171 |
Second Address | South Bend, IN 46601-1171 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 27/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
72064 | WELLMARK BCBS (01) | IA |