Healthcare Provider Details

I. General information

NPI: 1386647170
Provider Name (Legal Business Name): JOHN P. KARAGIANNIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 MEMORIAL DR STE 511
SOUTH BEND IN
46601-1075
US

IV. Provider business mailing address

3245 HEALTH DR STE 100
GRANGER IN
46530-1380
US

V. Phone/Fax

Practice location:
  • Phone: 574-544-5580
  • Fax: 574-544-5579
Mailing address:
  • Phone: 574-647-3725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number01041123A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: