Healthcare Provider Details

I. General information

NPI: 1013830967
Provider Name (Legal Business Name): ANDREA HOCHWALD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FAIRBANKS HALL 340 W. 10TH ST., SUITE 6200
INDIANAPOLIS IN
46202
US

IV. Provider business mailing address

1329 E JEFFERSON BLVD
SOUTH BEND IN
46617-3317
US

V. Phone/Fax

Practice location:
  • Phone: 574-229-8324
  • Fax:
Mailing address:
  • Phone: 574-229-8324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: