Walter D Kolmodin (NPI# 1265427645, PAC ID# 4082680186) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PODIATRY.
| Nation Provider ID (NPI) | 1265427645 |
| PAC ID by PECOS | 4082680186 |
| Professional Enrollment ID | I20040909000810 |
| Full Name | Walter D Kolmodin |
| Organization Legal Name | THE SOUTH BEND CLINIC LLP |
| Address |
4455 Edison Lakes Pkwy Mishawaka IN 46545-1442 |
| Phone Number | 5749680867 |
| Gender | M |
| Credential | DPM |
| Medical School | COLLEGE PODIATRIC MEDICINE AND SURGERY UNIVERSITY OF OSTEOPATHIC MEDICINE AND HEALTH SCIENCES |
| Graduation Year | 1998 |
| Primary Specialty | PODIATRY |
| Group Practice PAC ID | 3779577937 |
| Number of Group Practice Members | 139 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 150012 | SAINT JOSEPH REGIONAL MEDICAL CENTER |
| 150177 | UNITY MEDICAL AND SURGICAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 301 E Day Rd, Mishawaka, IN 46545-3455 | 5742046700 | THE SOUTH BEND CLINIC LLP |
| 4455 Edison Lakes Pkwy, Mishawaka, IN 46545-1442 | 5749680867 | THE SOUTH BEND CLINIC LLP |
| 211 N Eddy St, South Bend, IN 46617-2808 | 5742348161 | THE SOUTH BEND CLINIC LLP |
| Organization Legal Name | THE SOUTH BEND CLINIC LLP |
| Physicians | 152 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert A Cassady | Family Medicine | The South Bend Clinic LLP | 4440 Portage Ave, South Bend, IN 46628-9570 |
| Kathryn Latimer Werda | Physical Therapy | The South Bend Clinic LLP | 301 E Day Rd, Mishawaka, IN 46545-3455 |
| Kelly M Losiniecki | Nurse Practitioner | The South Bend Clinic LLP | 211 N Eddy St, South Bend, IN 46617-2808 |
| Robert Lee | Family Medicine | The South Bend Clinic LLP | 2102 E Inwood Rd, South Bend, IN 46614-2443 |
| Todd Rozycki | Dermatology | The South Bend Clinic LLP | 1802 Day Rd, Mishawaka, IN 46545-4329 |
| James B Harris | Allergy/immunology | The South Bend Clinic LLP | 234 C Waterfall Dr, Elkhart, IN 46516-3668 |
| Steven P Crowell | Internal Medicine | The South Bend Clinic LLP | 52500 Fir Rd, Granger, IN 46530-8579 |
| Enrique E Infante | Obstetrics/gynecology | The South Bend Clinic LLP | 14950 State Rd, Suite 23, Granger, IN 46530-7564 |
| Andrey P Seluzhitskiy | Family Medicine | The South Bend Clinic LLP | 8984 E Us Hwy 20, New Carlisle, IN 46552-9038 |
| Ralph E Inabnit | Family Medicine | The South Bend Clinic LLP | 211 N Eddy St, South Bend, IN 46617-2808 |
| Street Address |
4455 EDISON LAKES PKWY |
| City | MISHAWAKA |
| State | IN |
| Zip | 46545-1442 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mary P Kammann | Certified Registered Nurse Anesthetist (crna) | Cardinal Anesthesia LLC | 4455 Edison Lakes Pkwy, Mishawaka, IN 46545-1442 |
| Michael R Imperio | Certified Registered Nurse Anesthetist (crna) | Cardinal Anesthesia LLC | 4455 Edison Lakes Pkwy, Mishawaka, IN 46545-1442 |
| Jeffrey L Niespodziany | Podiatry | The South Bend Clinic LLP | 4455 Edison Lakes Pkwy, Mishawaka, IN 46545-1442 |
| William D Gilmer | Certified Registered Nurse Anesthetist (crna) | Cardinal Anesthesia LLC | 4455 Edison Lakes Pkwy, Mishawaka, IN 46545-1442 |
| Opeyemi A Awe | Internal Medicine | Rural Physicians Group Pannu Pllc | 4455 Edison Lakes Pkwy, 100 Unity Medical and Surgical Hospital, Mishawaka, IN 46545-1414 |
| Jonathan M Deming | Podiatry | The South Bend Clinic LLP | 4455 Edison Lakes Pkwy, Mishawaka, IN 46545-1442 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Marielvea A Banks | Physician Assistant | Pic Indiana PC | 505 W Cleveland Rd, Mishawaka, IN 46545-1003 |
| Sean R Horner | Physician Assistant | Pic Indiana PC | 505 W Cleveland Rd, Mishawaka, IN 46545-1003 |
| Rami Musleh | Physician Assistant | Pic Indiana PC | 505 W Cleveland Rd, Mishawaka, IN 46545-1003 |
| Meghan M Barrus | Physician Assistant | Pic Indiana PC | 505 W Cleveland Rd, Mishawaka, IN 46545-1003 |
| Ann M Grubb | Physician Assistant | Pic Indiana PC | 505 W Cleveland Rd, Mishawaka, IN 46545-1003 |
| Duane M Wampler | Physician Assistant | Pic Indiana PC | 505 W Cleveland Rd, Mishawaka, IN 46545-1003 |
| Eugene Huang | Emergency Medicine | Pic Indiana PC | 505 W Cleveland Rd, Mishawaka, IN 46545-1003 |
| Steven D Whaley | Anesthesiology | Pic Indiana PC | 505 W Cleveland Rd, Mishawaka, IN 46545-1003 |
| Angela Blagojevski | Physician Assistant | Pic Indiana PC | 505 W Cleveland Rd, Mishawaka, IN 46545-1003 |
| Danny E Winn | Physician Assistant | Pic Indiana PC | 505 W Cleveland Rd, Mishawaka, IN 46545-1003 |
| Find all physicians in zip 46545 | |||
| City | MISHAWAKA |
| Zip Code | 46545 |
| Specialty | PODIATRY |
| City + Specialty | MISHAWAKA + PODIATRY |
Please comment or provide details below to improve the information on Walter D Kolmodin.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.