Provider Demographics
NPI:1245228386
Name:HOWARD, MICHAEL DUANE (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DUANE
Last Name:HOWARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 N NILES AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46617-1924
Mailing Address - Country:US
Mailing Address - Phone:574-647-1610
Mailing Address - Fax:
Practice Address - Street 1:900 I ST
Practice Address - Street 2:
Practice Address - City:LAPORTE
Practice Address - State:IN
Practice Address - Zip Code:46350-5533
Practice Address - Country:US
Practice Address - Phone:219-324-1700
Practice Address - Fax:219-324-1710
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01030220A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100163720Medicaid
IN000000085123OtherBCBS BMG LAPORTE
IN100163720Medicaid
IN000000085123OtherBCBS BMG LAPORTE
IN565800EMedicare PIN