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NPI Code Detail

MEDICARE: DR. DAVID A CORY M.D.

MEDICARE: DR. DAVID A CORY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician01031493AIN

General Provider Information

NPI Number : 1184670382
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID A CORY M.D.
Provider Business Mailing Address
First Line : 121 S SAINT LOUIS BLVD
Second Line :
City : SOUTH BEND
State : IN
Zip : 46617-2924
Country : US
Telephone Number : 574-233-3123
Fax Number : 574-233-3125
Provider Business Practice Location Address
First Line : 121 S SAINT LOUIS BLVD
Second Line :
City : SOUTH BEND
State : IN
Zip : 46617-2924
Country : US
Telephone Number : 574-233-3123
Fax Number : 574-233-3125
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2006
Last Update Date : 12/07/2007

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Directions to “ DR. DAVID A CORY M.D.” Practice Location

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