Dr. James Edward Wack , MD
General Practice • South Bend, IN
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. James Wack has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Dr. James Wack, MD was a registered General Practice practicing in South Bend, IN. Throughout an active medical career spanning 11 years, Dr. Wack provided care at the practice location at 714 N MICHIGAN ST until profile deactivation on 2018-01-04.
Practice Location & Contact Primary Location
714 N Michigan St
South Bend, IN 466011035
Specialty Benchmarks & Practice Insights
Comparative analytics for General Practice in South Bend, IN
Practicing in South Bend, IN (190 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 208D00000X
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Practice Associates & Co-Workers
Healthcare professionals and specialists practicing at this location or sharing practice phone/fax
Student in an Organized Health Care Education/Training Program
Doctor of Medicine (M.D.)
Student in an Organized Health Care Education/Training Program
Doctor of Osteopathic Medicine (D.O.)
Family Medicine
Doctor of Medicine (M.D.)
Family Medicine
Doctor of Medicine (M.D.)
Family Medicine
Doctor of Medicine (M.D.)
Student in an Organized Health Care Education/Training Program
Doctor of Medicine (M.D.)
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on January 04, 2018
NPI status registered as active in NPPES database
Registered at 714 N MICHIGAN ST, SOUTH BEND, IN 466011035 (Tel: 5746477477)
Registered at 3355 DOUGLAS RD, SUITE 300, SOUTH BEND, IN 466351781
Recorded as JAMES WACK, MD
General Practice (License #01017207A in IN)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
3355 Douglas Rd, Suite 300
South Bend, IN 466351781
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