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Dr. Scott Alan Blickensderfer, DO
Urology Physician in South Bend, Indiana
NPI 1578568572

Scott Alan Blickensderfer is a Urology Physician based in South Bend, IN. Scott Alan Blickensderfer practices in South Bend, IN and has the professional credentials of DO. The NPI Number for Scott Alan Blickensderfer is 1578568572 and holds a License No. 02001398A (Indiana).

The current practice location address for Scott Alan Blickensderfer is 6301 University Commons, South Bend, IN and can be reached out via phone at 574-234-4100 and via fax at 574-282-1739.

Location: 6301 University Commons, South Bend, IN, 46635-1571
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Provider Profile Details
NPI Number
1578568572
Provider Name
Scott Alan Blickensderfer
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
6301 University Commons, South Bend, IN, 46635-1571
Phone Number
574-234-4100
Fax Number
574-282-1739
Provider Enumeration Date
06/16/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0000000234054 01 ANTHEM
264180V 01 IN MEDICARE PTAN
100093110 05 IN
institution
Provider Business Practice Location Address Details
Address
6301 University Commons
City
State
Zip
46635-1571
Phone Number
574-234-4100
Fax Number
574-282-1739
person
Provider Business Mailing Address Details
Address
6301 University Commons
City
State
Zip
46635-1571
Phone Number
574-234-4100
Fax Number
574-282-1739
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Urology
Speciality
-
Taxonomy
License No.
02001398A (Indiana)
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
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