DR. EDWARD DANIEL NUSBAUM (NPI# 1528274313) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528274313 |
| Entity Type | Individual |
| Full Name | DR. EDWARD DANIEL NUSBAUM |
| Credential | M.D. |
| Practice Address |
403 E Madison St South Bend IN 46617-2322 |
| Mailing Address |
Po Box 809 Goshen IN 46527-0809 |
| Practice Telephone | 5742831234 |
| Mailing Telephone | 5745331234 |
| Mailing Fax Number | 5745372652 |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2012-02-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
01063675A | IN | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
01063675A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DEA | FN0237140 | 01 | |
| IN | INDIANA PHYSICIAN LICENSE | 01063675A | 01 |
| Street Address |
403 E MADISON ST |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46617-2322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164497962 | Phillip Coffey | Social Worker | 403 E Madison St, South Bend, IN 46617-2322 | 2006-02-23 |
| 1134534456 | Memorial Hospital of South Bend, Inc | General Acute Care Hospital | 403 E Madison St, South Bend, IN 46617-2322 | 2014-06-25 |
| 1225310402 | Susan K Henderson | Counselor | 403 E Madison St, South Bend, IN 46617-2322 | 2011-09-14 |
| 1154633550 | Meladie A Langham | Counselor | 403 E Madison St, South Bend, IN 46617-2322 | 2010-07-14 |
| 1497067896 | Kami S Brenneman | Counselor | 403 E Madison St, South Bend, IN 46617-2322 | 2010-07-14 |
| 1396064309 | Casandra Mcgrew | Counselor | 403 E Madison St, South Bend, IN 46617-2322 | 2010-06-01 |
| 1124347133 | Amanda Jardine | Counselor | 403 E Madison St, South Bend, IN 46617-2322 | 2010-06-01 |
| 1104141985 | Aaron T Gray | Counselor | 403 E Madison St, South Bend, IN 46617-2322 | 2010-04-05 |
| 1346579679 | Linda S Hoppel | Counselor | 403 E Madison St, South Bend, IN 46617-2322 | 2009-12-16 |
| 1235468570 | Michelle M Peters | Social Worker | 403 E Madison St, South Bend, IN 46617-2322 | 2009-12-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740731116 | Jack Mcintyre Kimmell | Specialist/Technologist | 1526 East Lasalle, South Bend, IN 46617 | 2016-10-20 |
| 1023429115 | Morning View Assisted Living LLC | Assisted Living Facility | 475 N. Niles Avenue, South Bend, IN 46617 | 2014-05-12 |
| 1265861231 | Rebecca Busenbark | Physical Therapist | 401 E Colfax Ave Ste 102, South Bend, IN 46617 | 2013-11-11 |
| 1962709071 | Doreen Danice Huddleston | Social Worker | 928 East Wayne St, Suit C, South Bend, IN 46617 | 2011-02-25 |
| 1487981734 | Mary Cecilia Roemer | Marriage & Family Therapist | 616 E. Colfax Ave, South Bend, IN 46617 | 2009-11-06 |
| 1225264054 | Sridhar Meda | Dentist | 1005 East Lasalle Ave, South Bend, IN 46617 | 2009-06-08 |
| 1063673531 | Madeline Christina Watkins | Counselor | 616 E Colfax, South Bend, IN 46617 | 2008-06-18 |
| 1437366481 | Michael Reed Johns | Dentist | 103 South Eddy Street, South Bend, IN 46617 | 2007-05-17 |
| 1194937680 | Sarah Elizabeth Redman | Specialist/Technologist | 53880 Carmichael Dr., South Bend, IN 46617 | 2007-05-04 |
| 1124241211 | Trixy Franke | Family Medicine | 837 E. Cedar St., Ste 100, South Bend, IN 46617 | 2007-04-10 |
| Find all providers in zip 46617 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861421141 | Beacon Medical Group, Inc. | Psychiatry & Neurology | 100 Navarre Pl Ste 6600, South Bend, IN 46601 | 2006-06-30 |
| 1821024043 | Virgil A Dibiase | Psychiatry & Neurology | 707 N Michigan St Ste 102, South Bend, IN 46601-1068 | 2006-06-23 |
| 1316936123 | John G Aranda | Psychiatry & Neurology | 1619 E Colfax Ave, South Bend, IN 46617-2603 | 2005-10-14 |
| 1528201076 | Thomas Leahy | Psychiatry & Neurology | 112 W Jefferson Blvd, Ste 600, South Bend, IN 46601-1923 | 2009-04-14 |
| 1134378375 | Satya N Ramiah | Psychiatry & Neurology | 615 N Michigan St, South Bend, IN 46601-1033 | 2008-09-11 |
| 1336352806 | Jose Luis Lopez Jr. | Psychiatry & Neurology | 615 N Michigan St, South Bend, IN 46601-1033 | 2007-05-08 |
| 1134262595 | North Central Neurology, LLC | Psychiatry & Neurology | 621 Memorial Dr, Suite 624, South Bend, IN 46601-1063 | 2007-02-15 |
| 1720016926 | James W Kozelka | Psychiatry & Neurology | 707 N Michigan St Ste 102, South Bend, IN 46601-1068 | 2006-06-28 |
| 1033165428 | Kathryn A. Hanlon | Psychiatry & Neurology | 1815 E Ireland Rd, South Bend, IN 46614-2845 | 2006-05-26 |
| 1043208739 | Bridget Patterson-marshall | Psychiatry & Neurology | 615 N Michigan St, South Bend, IN 46601-1033 | 2005-10-07 |
| Find all providers in SOUTH BEND | ||||
| City | SOUTH BEND |
| Zip Code | 46617 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.