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General NPI Number Information
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NPI Number | 1952509853
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Entity Type | Individual
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Provider Name | DAVID WILLIAM AMRHEIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 03/30/2021
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Provider Practice Location Address
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Address Line | 6913 N MAIN ST STE 300
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City | GRANGER
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State | IN
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Zip | 46530-8039
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Country | US
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Telephone | 574-647-1500
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Fax | 574-647-2567
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Provider Business Mailing Address
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Address Line | 710 N NILES AVE
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City | SOUTH BEND
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State | IN
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Zip | 46617-1924
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Country | US
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Telephone | 574-647-1610
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01065766A
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License Number State | IN
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