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General NPI Number Information
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NPI Number | 1184988685
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Entity Type | Individual
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Provider Name | PAUL DANIEL JUDGE MD
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Gender | Male
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Dates
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Enumeration Date | 06/28/2012
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 611 E DOUGLAS RD STE 203
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City | MISHAWAKA
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State | IN
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Zip | 46545-1467
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Country | US
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Telephone | 574-335-6640
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Fax | 574-335-0621
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Provider Business Mailing Address
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Address Line | 5215 HOLY CROSS PKWY
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City | MISHAWAKA
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State | IN
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Zip | 46545-1469
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 4301116557
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License Number State | IN
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