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DR. GLEN A DAVIS MD
NPI 1528058344
Pediatrics in South Bend, IN

Active since October 24, 2005
211 N EDDY ST, SOUTH BEND, IN 46617(574) 233-7337(574) 239-1561 Get Directions Write a Review

NPPES record last updated: June 6, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Glen A Davis Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. GLEN A DAVIS MD (NPI 1528058344) is an individual pediatrics provider in South Bend, Indiana, licensed in Indiana (01053925A) and active in the NPI registry since October 2005.

NPPES Registry Identity

NPI1528058344
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameDR. GLEN A DAVISCredential: MD
Location Address211 N EDDY STSouth Bend, IN 46617-2808
Mailing Address211 N Eddy StSouth Bend, IN 46617-2808 · (574) 233-7337 · Fax (574) 239-1561
Phone(574) 233-7337
Fax(574) 239-1561
Sole ProprietorNo
Enumeration DateOctober 24, 2005
Last NPPES UpdateJune 6, 2008
✔ NPI 1528058344 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in IN · 01053925A
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
211 N EDDY ST, South Bend, IN 46617
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Other Identifiers 3

Medicare ID-Type Unspecified200354660IN
Medicare ID-Type Unspecified146470A7IN
Medicare UPINI15871IN

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AUTUMN MARIE HANNA PA
Physician Assistant
211 N EDDY ST
SOUTH BEND, IN 46617
St. Joseph County (574) 234-8161
DR. STEVEN P. CROWELL MD
Internal Medicine
211 N EDDY ST
SOUTH BEND, IN 46617
St. Joseph County (574) 237-9340
JESSICA A HECKMAN R.D.
Dietitian, Registered
211 N EDDY ST
SOUTH BEND, IN 46617
St. Joseph County (574) 237-9331
LOUIS CAVADINI DO
Family Medicine
211 N EDDY ST
SOUTH BEND, IN 46617
St. Joseph County (574) 237-9395
MS. REGINA R. JASIEWICZ FNP
Nurse Practitioner (Family)
211 N EDDY ST
SOUTH BEND, IN 46617
St. Joseph County (574) 237-9231
DR. ERSALAN A RAHMAN M.D.
Ophthalmology
211 N EDDY ST
SOUTH BEND, IN 46617
St. Joseph County (574) 237-9334
DR. SCOTT H WOLF MD
Radiology (Diagnostic Radiology)
211 N EDDY ST
SOUTH BEND, IN 46617
St. Joseph County (574) 237-9203
GABRIELA L TAYLOR PA
Physician Assistant
211 N EDDY ST
SOUTH BEND, IN 46617
St. Joseph County (574) 237-9294

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Glen Davis's NPI number?

The NPI number for Glen Davis is 1528058344. It was assigned to this individual provider in the NPPES registry on October 24, 2005.

Where is Glen Davis located?

Glen Davis practices at 211 N Eddy St, South Bend, IN 46617. The listed phone number is (574) 233-7337.

What is Glen Davis's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

When was this NPI record last updated?

The NPPES record for Glen Davis was last updated on June 6, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.