Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 01068595A | IN |
NPI | 1326065285 |
---|---|
Provider Name | Samira Hassan El-Zind |
First Address | South Bend, IN 46617-1924 |
Second Address | South Bend, IN 46601-1169 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2006 |
Last Update Date | 01/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000736243 | BCBS MEMORIAL CHILDRENS (01) | IN |
201009540 | (05) | IN |
259900004 | MEDICARE PTAN (01) | IN |
G42348 | (02) |