Provider Demographics
NPI:1972552636
Name:ENGEL, HOWARD R (MD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:R
Last Name:ENGEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:810 PARK PL
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-3520
Mailing Address - Country:US
Mailing Address - Phone:574-472-6766
Mailing Address - Fax:574-472-6774
Practice Address - Street 1:707 CEDAR ST
Practice Address - Street 2:SUITE 350
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46617-2054
Practice Address - Country:US
Practice Address - Phone:574-472-6450
Practice Address - Fax:574-472-6474
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2008-05-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01018700207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN10220610Medicaid
D94951Medicare UPIN
IN10220610Medicaid