Provider Demographics
NPI:1649225095
Name:ALLIED HEMATOLOGY ONCOLOGY ASSOCIATES LLC
Entity Type:Organization
Organization Name:ALLIED HEMATOLOGY ONCOLOGY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMANDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:574-968-4100
Mailing Address - Street 1:6319 STATE ROAD 23
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46635-1475
Mailing Address - Country:US
Mailing Address - Phone:574-968-4100
Mailing Address - Fax:574-968-4125
Practice Address - Street 1:6319 STATE ROAD 23
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46635-1475
Practice Address - Country:US
Practice Address - Phone:574-968-4100
Practice Address - Fax:574-968-4125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN220260Medicare ID - Type Unspecified