Search › Indiana › 207QS0010X
Mitchell Daugherty
NPI 1417481540 · on the registry since 2017
Practice
- Address
- 1815 E Ireland Rd
South Bend, IN 46614 - Phone
- (574) 647-1700
- Fax
- (574) 647-7572
- Organisation at this address
- Beacon Medical Group, Inc.
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 45
Additional practice sites
- 100 Navarre Pl Ste 4440, South Bend, IN
- 714 N Michigan St, South Bend, IN
- 900 I St, La Porte, IN
- 111 W Jefferson Blvd Ste 100, South Bend, IN
Registry record
- Primary taxonomy
- 207QS0010X
207QS0010X
- Also registered as
- 207Q00000X
- Licence states on file
- IN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2025-06-20
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Indiana