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General NPI Number Information
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NPI Number | 1538585187
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Entity Type | Organization
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Legal Business Name | SAINT JOSEPH REGIONAL MEDICAL CENTER- PLYMOUTH CAMPUS INC
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Dates
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Enumeration Date | 03/06/2014
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 1919 LAKE AVE STE 102B
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City | PLYMOUTH
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State | IN
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Zip | 46563-7830
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Country | US
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Telephone | 574-335-6800
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Fax | 574-948-5480
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Provider Business Mailing Address
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Address Line | 5215 HOLY CROSS PARKWAY SAINT JOSEPH PROVIDER SERVICES
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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 | 574-335-8707
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Fax | 574-335-0741
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. CHRISTOPHER JAMES KARAM
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Credential |
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Telephone | 574-335-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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