DR. MICHAEL JOSEPH DESTEFANO (NPI# 1609864040) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609864040 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL JOSEPH DESTEFANO |
| Credential | M.D. |
| Practice Address |
100 Navarre Pl Ste. 4470 South Bend IN 46601-1156 |
| Mailing Address |
3355 Douglas Rd Ste. 300 South Bend IN 46635-1781 |
| Practice Telephone | 5746471300 |
| Mailing Telephone | 5746471069 |
| Mailing Fax Number | 5746471825 |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2008-04-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 01027434A | IN | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447873369 | Michael Destefano | Physical Therapy Assistant | 6010 Bay Pkwy Fl 1, Brooklyn, NY 11204-6079 | 2020-05-27 |
| 1407200116 | Michael Destefano | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2119 | 2016-04-19 |
| 1982972378 | Michael A Destefano | Psychologist | 14 S Bryn Mawr Ave, Suite 205, Bryn Mawr, PA 19010-3216 | 2011-12-13 |
| 1326369943 | Michael William Destefano | Radiology | 1 Cooper Plz, Camden, NJ 08103 | 2010-06-17 |
| 1295912988 | Michael G Destefano | Psychologist | 10333 El Camino Real, Atascadero, CA 93422-5808 | 2008-01-25 |
| 1588796320 | Michael Don Destefano | Pediatrics | 7000 W 111th St, Worth, IL 60482-1851 | 2007-03-09 |
| 1972536712 | Michael J Destefano | Social Worker | 110 Lincoln Street, Ridgway, PA 15853 | 2006-07-07 |
| Street Address |
100 NAVARRE PL STE. 4470 |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46601-1156 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184629891 | Sharon K Klingerman | Nurse Practitioner | 100 Navarre Pl, Ste 5550, South Bend, IN 46601-1169 | 2005-06-17 |
| 1699215582 | Kaytlyn K Caffery | Physician Assistant | 100 Navarre Pl, Suite 4470, South Bend, IN 46601-1156 | 2017-02-27 |
| 1063841252 | Julie Horsting | Genetic Counselor, MS | 100 Navarre Pl, Suite 4410, South Bend, IN 46601-1156 | 2013-11-07 |
| 1831522465 | Andrea J. Karweck | Psychologist | 100 Navarre Pl, Suite 5550, South Bend, IN 46601-1156 | 2013-08-19 |
| 1841623188 | Elizabeth Lynn Younker | Audiologist | 100 Navarre Pl, Suite 4430, South Bend, IN 46601-1156 | 2013-08-09 |
| 1356690150 | Ashley Carpenter | Physical Therapist | 100 Navarre Pl, Suite 6650, South Bend, IN 46601-1156 | 2012-09-07 |
| 1932488665 | Abhishek Das | Physical Medicine & Rehabilitation | 100 Navarre Pl, Suite 660, South Bend, IN 46601-1156 | 2011-08-11 |
| 1508163999 | Melissa Christine Quimby | Nurse Practitioner | 100 Navarre Pl, Suite 5550, South Bend, IN 46601-1156 | 2011-02-21 |
| 1457658130 | Crystal S Beneker | Nurse Practitioner | 100 Navarre Pl, Suite 6600, South Bend, IN 46601-1156 | 2011-02-16 |
| 1437454808 | Sally Elizabeth Hull | Nurse Practitioner | 100 Navarre Pl, Suite 6600, South Bend, IN 46601-1156 | 2011-01-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447610449 | David Thomas | Hearing Instrument Specialist | 808 S Michigan St., South Bend, IN 46601 | 2016-03-03 |
| 1285072454 | Kevin Francis Cumper | Internal Medicine | 621 Memorial Dr Ste 624, South Bend, IN 46601 | 2013-06-11 |
| 1952605560 | Robert Lusk Bonham | Dentist | 1222 L.w.e., So. Bend, IN 46601 | 2010-12-23 |
| 1649580911 | Daniel Scott Debrule | Psychologist | 211 W. Washington Street, Suite 2311, South Bend, IN 46601 | 2010-10-20 |
| 1528390770 | Luke Alfred White | Internal Medicine | 615 N. Michigan St., Memorial Hospital, C/o Erin Smith, South Bend, IN 46601 | 2010-02-12 |
| 1548497837 | Tmg Home Health Care | Home Health | 108 N Main St #305, South Bend, IN 46601 | 2009-06-15 |
| 1225283039 | Jody L. Hughes | Counselor | 202 S. Michigan Street, Suite 875, South Bend, IN 46601 | 2008-11-20 |
| 1740432574 | Amanda Jayne Quicksall | Social Worker | 611 Lincolnway W, South Bend, IN 46601 | 2008-10-10 |
| 1952565772 | Thomas P Judd | Dentist | 1901 #b Western Avenue, Ihc South Bend, South Bend, IN 46601 | 2008-07-10 |
| 1851590269 | Warren Larry Penrod | Nurse Practitioner | 333 W. Western Ave, South Bend, IN 46601 | 2007-07-16 |
| Find all providers in zip 46601 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073714549 | Zhiquan Zhao | Obstetrics & Gynecology | 6301 University Commons Ste 310, Ob/gyn Office, South Bend, IN 46635-1479 | 2007-05-30 |
| 1669424792 | Christopher S Norborg | Obstetrics & Gynecology | 515 N Lafayette Blvd, South Bend, IN 46601-1003 | 2006-05-17 |
| 1598739492 | Elaine Marie Carroll | Obstetrics & Gynecology | 100 Navarre Pl Ste 4410, South Bend, IN 46601 | 2006-02-15 |
| 1174503866 | Ted M. Roth | Obstetrics & Gynecology | 621 Memorial Dr Ste 302, South Bend, IN 46601-1073 | 2006-01-19 |
| 1508857806 | Ilana Tamir Kirsch | Obstetrics & Gynecology | 6301 University Commons Ste 210, South Bend, IN 46635 | 2005-11-04 |
| 1477903391 | Mackenzie Austgen | Obstetrics & Gynecology | 515 N Lafayette Blvd, South Bend, IN 46601-1003 | 2016-06-22 |
| 1497146252 | Donna Joan Harrison | Obstetrics & Gynecology | 6301 University Commons, Suite 310, South Bend, IN 46635-1571 | 2015-02-13 |
| 1386063345 | Erin Hendricks Krizman | Obstetrics & Gynecology | 6301 University Commons Ste 310, South Bend, IN 46635 | 2014-04-07 |
| 1043654361 | Sara A Baumgartner | Obstetrics & Gynecology | 6301 University Commons Ste 310, South Bend, IN 46635-1479 | 2013-04-18 |
| 1164764890 | Jessica Marie Basham | Obstetrics & Gynecology | 515 N Lafayette Blvd, South Bend, IN 46601-1003 | 2013-03-20 |
| Find all providers in SOUTH BEND | ||||
| City | SOUTH BEND |
| Zip Code | 46601 |
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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.