Healthcare Provider Details

I. General information

NPI: 1306136650
Provider Name (Legal Business Name): MIKHAIL M GALPERIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2011
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5215 HOLY CROSS PKWY
MISHAWAKA IN
46545-1469
US

IV. Provider business mailing address

121 S SAINT LOUIS BLVD
SOUTH BEND IN
46617-2924
US

V. Phone/Fax

Practice location:
  • Phone: 574-335-5000
  • Fax: 574-233-3123
Mailing address:
  • Phone: 240-678-2336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number036169774
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number01075196A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: