Provider Demographics
NPI:1720246572
Name:WALTER J FILIPEK MD
Entity Type:Organization
Organization Name:WALTER J FILIPEK MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:J
Authorized Official - Last Name:FILIPEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:574-288-8000
Mailing Address - Street 1:707 N MICHIGAN STREET
Mailing Address - Street 2:# 318
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46601-1070
Mailing Address - Country:US
Mailing Address - Phone:574-288-8000
Mailing Address - Fax:574-288-8088
Practice Address - Street 1:707 N MICHIGAN STREET
Practice Address - Street 2:# 318
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46601-1070
Practice Address - Country:US
Practice Address - Phone:574-288-8000
Practice Address - Fax:574-288-8088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01024470B225500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100186060AMedicaid
IN000000213208OtherBCBS
IN100186060AMedicaid