MEDICARE: CHARLES HIGGS-COULTHARD 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
1	207Q00000X	Family Medicine Physician	01042925	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447205448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES HIGGS-COULTHARD M.D.

Provider Business Mailing Address
First Line	:	707 E CEDAR ST
Second Line	:	STE 200
City	:	SOUTH BEND
State	:	IN
Zip	:	46617-2057
Country	:	US
Telephone Number	:	574-335-8700
Fax Number	:	574-335-0760

Provider Business Practice Location Address
First Line	:	611 E DOUGLAS RD STE 406
Second Line	:
City	:	MISHAWAKA
State	:	IN
Zip	:	46545-1468
Country	:	US
Telephone Number	:	574-335-6580
Fax Number	:	574-335-0796

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	10/25/2023

Similar Medicare Providers

1760365530 — ANNALIESA FANGUY MD
Practice Location Address:

611 E DOUGLAS RD STE 407
MISHAWAKA, IN
46545-1468

Practice Phone: 574-335-6500
Practice Fax:

1699767152 — DR. EDWARD P. SHERIDAN PHARMD, BCPS, BCACP
Practice Location Address:

611 E DOUGLAS RD STE 412
MISHAWAKA, IN
46545-1468

Practice Phone: 574-335-6514
Practice Fax:

1386683522 — MARYJO MEIER M.D.
Practice Location Address:

611 E DOUGLAS RD STE 401
MISHAWAKA, IN
46545-1468

Practice Phone: 574-335-6242
Practice Fax: 574-335-0758

1023035508 — THEODORE R NEUMANN MD
Practice Location Address:

611 E DOUGLAS RD STE 406
MISHAWAKA, IN
46545-1468

Practice Phone: 574-335-6580
Practice Fax:

1376553172 — ANGELINA SAGARSEE PHARMD
Practice Location Address:

611 E DOUGLAS RD STE 412
MISHAWAKA, IN
46545-1468

Practice Phone: 574-335-6500
Practice Fax:

1780766261 — SAINT JOSEPH REGIONAL MEDICAL CENTER-SOUTH BEND CAMPUS, INC.
Practice Location Address:

611 E DOUGLAS RD, STE 407 , FAMILY MEDICINE CENTER OF SJRMC
MISHAWAKA, IN
46545-1468

Practice Phone: 574-335-6500
Practice Fax: 574-335-0772

Directions to “ CHARLES HIGGS-COULTHARD M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.