HOWARD ELVINDO WIARDA (NPI# 1801881255) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801881255 |
| Entity Type | Individual |
| Full Name | HOWARD ELVINDO WIARDA |
| Credential | MD |
| Practice Address |
621 Memorial Dr Ste 312 South Bend IN 46601 |
| Mailing Address |
2300 N Edward St Decatur IL 62526-4163 |
| Practice Telephone | 5746475200 |
| Mailing Telephone | 2178762300 |
| Mailing Fax Number | 2178766725 |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2018-07-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085B0100X |
Radiology Specialization: Body Imaging |
01052406 | IN | Allopathic & Osteopathic Physicians |
| N | 2085N0700X |
Radiology Specialization: Neuroradiology |
01052406 | IN | Allopathic & Osteopathic Physicians |
| N | 2085N0904X |
Radiology Specialization: Nuclear Radiology |
01052406 | IN | Allopathic & Osteopathic Physicians |
| N | 2085P0229X |
Radiology Specialization: Pediatric Radiology |
01052406 | IN | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
01052406 | IN | Allopathic & Osteopathic Physicians |
| N | 2085R0203X |
Radiology Specialization: Therapeutic Radiology |
01052406 | IN | Allopathic & Osteopathic Physicians |
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
01052406A | IN | Allopathic & Osteopathic Physicians |
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
01052406 | IN | Allopathic & Osteopathic Physicians |
| N | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
01052406 | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | MEDICARE- BMG VEIN SPECIALISTS | M16930802 | 01 |
| IN | MEDICARE- BMG VASCULAR INTERVENTIONAL RADIOLOGY | M16930802 | 01 |
| IN | 200261430 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2300 N Edward St, Decatur, IL 625264163 | 2178762300 | 2178766725 |
| 233 Florence Ave, Granger, IN 465308048 | 5746473990 |
| Street Address |
621 MEMORIAL DR STE 312 |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124671813 | Amanda Ann Aldana | Nurse Practitioner | 621 Memorial Dr Ste 312, South Bend, IN 46601-1073 | 2019-07-22 |
| 1932468352 | Beacon Medical Group, Inc. | Radiology | 621 Memorial Dr Ste 312, South Bend, IN 46601-1073 | 2012-05-04 |
| 1376845073 | Stacy L Mc Dowell | Clinical Nurse Specialist | 621 Memorial Dr Ste 312, South Bend, IN 46601-1073 | 2010-12-01 |
| 1689669715 | Kevin M Small | Radiology | 621 Memorial Dr Ste 312, South Bend, IN 46601-1073 | 2005-09-14 |
| 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 | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154856789 | Xrc Clinical Radiology, LLC | Radiology | 121 S Saint Louis Blvd, South Bend, IN 46617-2924 | 2017-04-20 |
| 1932468352 | Beacon Medical Group, Inc. | Radiology | 621 Memorial Dr Ste 312, South Bend, IN 46601-1073 | 2012-05-04 |
| 1841434354 | Kelly Elizabeth Mortell | Radiology | 621 Memorial Dr, Ste 312, South Bend, IN 46601-1063 | 2009-04-28 |
| 1093893026 | Michael John Hall | Radiology | 621 Memorial Dr, Ste 312, South Bend, IN 46601-1063 | 2006-11-01 |
| 1689669715 | Kevin M Small | Radiology | 621 Memorial Dr Ste 312, South Bend, IN 46601-1073 | 2005-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306317565 | Donita Renee Morris | Radiology | 6910 N Oxford St, Indianapolis, IN 46220-2255 | 2018-12-16 |
| 1174099147 | Omnivas Nwi | Radiology | 8127 Merrillville Rd Ste 1, Merrillville, IN 46410-6306 | 2018-10-17 |
| 1669982492 | Us Access Care of Indianapolis, LLC | Radiology | 201 North Illinois St, 16th Floor - South Tower, Indianapolis, IN 46204-4618 | 2017-10-06 |
| 1487038360 | Beacon Medical Group, Inc. | Radiology | 233 Florence Ave, Granger, IN 46530-8048 | 2015-07-10 |
| 1396075982 | Ir Halum, LLC | Radiology | 5953 Calais Ct, Indianapolis, IN 46220-6004 | 2010-01-05 |
| 1952307480 | Joseph W Eke Jr. | Radiology | 711 S East St, Indianapolis, IN 46225-1317 | 2005-06-21 |
| 1053922849 | Ultrasonic Medical Specialists LLC | Radiology | 365 Conestoga Dr, Chesterton, IN 46304-1559 | 2020-08-13 |
| 1912522368 | Ng Medical Center LLC | Radiology | 5900 Hohman Ave, Hammond, IN 46320-2423 | 2020-06-11 |
| 1487176004 | Modern Vascular and Vein Center LLC | Radiology | 951 Transport Dr, Valparaiso, IN 46383-8434 | 2017-07-14 |
| 1952772782 | Nuvena Vein Center, LLC | Radiology | 3707 New Vision Dr, Fort Wayne, IN 46845-1702 | 2015-10-20 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH BEND |
| Zip Code | 46601 |
Please comment or provide details below to improve the information on HOWARD ELVINDO WIARDA.
| 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.