Healthcare Provider Details

I. General information

NPI: 1205321536
Provider Name (Legal Business Name): HARMANJOT SINGH KHAIRA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2018
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 MEMORIAL DRIVE STE 302
SOUTH BEND IN
46601-1073
US

IV. Provider business mailing address

3245 HEALTH DR STE 100
GRANGER IN
46530-1380
US

V. Phone/Fax

Practice location:
  • Phone: 574-246-9350
  • Fax: 574-246-9370
Mailing address:
  • Phone: 574-647-3725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number01093309A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number01093309A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: