Organization Active NPI

Stephen F. Mitros, M.D., P.C.

  • Adult Reconstructive Orthopaedic Surgery Physician
  • South Bend, IN
National Provider Identifier
1639340672
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
01030913 Issued in IN
Legal business name
STEPHEN F. MITROS, M.D., P.C.
Practice address
720 Cedar St Ste 160
South Bend, IN 46617-2093
Phone
(574) 232-7064
Fax
(574) 232-7136
NPI assigned
Mar 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Stephen F Mitros, M.D.
Title
President
Phone
(574) 232-7064

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XS0114X 01030913 IN Primary

Addresses

Primary practice location

720 Cedar St Ste 160
South Bend, IN 46617-2093

Mailing address

720 Cedar St Ste 160
South Bend, IN 46617-2093
Phone (574) 232-7064

National Provider Directory

National Provider Directory

Locations

621 Memorial Dr
Ste 612
South Bend, IN 46601
Phone (574) 232-3325

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205798400000",
    "number": "1639340672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 CEDAR ST STE 160",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172093",
            "telephone_number": "574-232-7064",
            "fax_number": "574-232-7136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 CEDAR ST STE 160",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172093",
            "telephone_number": "574-232-7064",
            "fax_number": "574-232-7136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN F. MITROS, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-18",
        "last_updated": "2008-03-18",
        "status": "A",
        "authorized_official_last_name": "MITROS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "574-232-7064",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "IN",
            "license": "01030913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.