Healthcare Provider Details
I. General information
NPI: 1780766261
Provider Name (Legal Business Name): SAINT JOSEPH REGIONAL MEDICAL CENTER-SOUTH BEND CAMPUS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/20/2006
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
611 E DOUGLAS RD, STE 407 FAMILY MEDICINE CENTER OF SJRMC
MISHAWAKA IN
46545-1468
US
IV. Provider business mailing address
5215 HOLY CROSS PKWY
MISHAWAKA IN
46545-1469
US
V. Phone/Fax
- Phone: 574-335-6500
- Fax: 574-335-0772
- Phone: 574-335-8707
- Fax: 574-335-0741
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XX0004X |
| Taxonomy | Orthopaedic Foot and Ankle Surgery Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QS0010X |
| Taxonomy | Sports Medicine (Family Medicine) Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VM0101X |
| Taxonomy | Maternal & Fetal Medicine Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTOPHER
JAMES
KARAM
Title or Position: PRESIDENT
Credential:
Phone: 574-335-5000