Provider Demographics
NPI:1437191665
Name:HELMS, MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:HELMS
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 1:15944 ELMSFORD CT
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-7070
Mailing Address - Country:US
Mailing Address - Phone:574-286-2432
Mailing Address - Fax:
Practice Address - Street 1:2930 W CLEVELAND RD
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46628-6090
Practice Address - Country:US
Practice Address - Phone:574-335-8450
Practice Address - Fax:574-335-0780
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01038531207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000927895OtherBCBS PC
IN000000215759OtherBCBS
IN000000927895OtherBCBS PC
ININ2068003Medicare PIN
ININ1133010Medicare PIN
INE17124Medicare UPIN
IN100370170AMedicaid
IN187710DMedicare PIN