Provider Demographics
NPI:1285734780
Name:POSAR, TODD J (DC)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:J
Last Name:POSAR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6128
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46660-6128
Mailing Address - Country:US
Mailing Address - Phone:574-271-7300
Mailing Address - Fax:574-272-8790
Practice Address - Street 1:1635 N IRONWOOD DR
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46635-1891
Practice Address - Country:US
Practice Address - Phone:574-271-7300
Practice Address - Fax:574-272-8790
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08000789A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000241558OtherBCBS GROUP ID
IN000000241561OtherBLUE CROSS BLUE SHIELD
INP00081992OtherMEDICARE RAILROAD
IN000000241558OtherBCBS GROUP ID