Leroy D Weaver Jr. Diagnostic Radiology
615 N Michigan, South Bend, IN 46601-1033


Leroy D Weaver Jr. is physician registered in the Centers for Medicare & Medicaid Services (CMS). The National Provider Identifier (NPI) of the National Plan and Provider Enumeration System (NPPES) is 1710950258. The unique individual professional ID assigned by Provider Enrollment, Chain, and Ownership System (PECOS) is 5991736571. The medical credential is MD. The primary specialty is DIAGNOSTIC RADIOLOGY. The organization is RADIOLOGY, INC. The address is 615 N Michigan, South Bend, IN 46601-1033. The zip code is 46601.


Leroy D Weaver Jr. · 615 N Michigan, South Bend, IN 46601-1033

Nation Provider ID 1710950258
PAC ID by PECOS 5991736571
Professional Enrollment ID I20060612000231
Last Name WEAVER
First Name LEROY
Middle Name D
Suffix JR.
Gender M
Credential MD
Medical School Name INDIANA UNIVERSITY SCHOOL OF MEDICINE
Graduation Year 2000
Primary Specialty DIAGNOSTIC RADIOLOGY
Primary Specialty RADIOLOGY, INC
Phone Number 5742843086
Group Practice PAC ID 5890695464
Number of Group Practice Members 39
Address 615 N MICHIGAN
SOUTH BEND, IN 466011033
Claims Based Hospital Affiliation Claim Control Number (CCN): 150026
Legal Business Name: IU HEALTH GOSHEN HOSPITAL
Claims Based Hospital Affiliation Claim Control Number (CCN): 150018
Legal Business Name: ELKHART GENERAL HOSPITAL
Claims Based Hospital Affiliation Claim Control Number (CCN): 150058
Legal Business Name: MEMORIAL HOSPITAL OF SOUTH BEND
Claims Based Hospital Affiliation Claim Control Number (CCN): 150146
Legal Business Name: PARKVIEW NOBLE HOSPITAL
Claims Based Hospital Affiliation Claim Control Number (CCN): 151300
Legal Business Name: COMMUNITY HOSPITAL OF BREMEN INC
Professional accepts Medicare Assignment Y
Report Quality Measures Y

street_number: 615
route: North Michigan Street (N Michigan St)
locality, political: South Bend
admin_level_3, political: Portage Township
admin_level_2, political: St. Joseph County (St Joseph County)
admin_level_1, political: Indiana (IN)
country, political: United States (US)
postal_code: 46601
types : street_address
latitude: 41.6838386
longitude: -86.2517326
latlng: (41.6838386, -86.2517326)


Radiology, Inc · Medicare Physician

Name Address Specialty
John Depersio 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Thomas Rhee 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Allison Lamont 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
David D Andrea 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Jody Barber 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Krishna Pillai 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Brian Bolinger 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Nazar Golewale 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Sridevi Kanuri 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Jonathan Weiss 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Smari Thordarson 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Katrina Vanderveen 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Russell Midkiff 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Stephen Kim 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Syed Ali 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Edward Neyman 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Justin Lightburn 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Pedro Miro 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Irfan Ahmad 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Alphonse Harding 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY

Zip 46601 · Diagnostic Radiology · Medicare Physician

Name Address Specialty
Krishna Pillai 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Albert Cho 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Gerard Duprat 615 N Michigan St 1st Flr, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Pedro Miro 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
John Depersio 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Justin Lightburn 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Katrina Vanderveen 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
David D Andrea 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Mark Ormson 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
John Hill 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Jack Markiewicz 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Thomas Rhee 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Alan Engel 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Russell Midkiff 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Alexander Tawadros 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Brian Bolinger 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Jonathan Weiss 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Jody Barber 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Edward Neyman 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY
Christine Omalley 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY

Zip 46601 · Medicare Physician

Name Address Specialty
Randal Bladel 615 N Michigan St, South Bend, IN 46601-1033 ANESTHESIOLOGY
Szabolcs Szabo 610 N Michigan St, South Bend, IN 46601-1081 INTERVENTIONAL CARDIOLOGY
Kirk Bodach 615 N Michigan St 1st Flr, South Bend, IN 46601-1033 FAMILY PRACTICE
Dana Brackett 100 Navarre Pl, South Bend, IN 46601-1172 NURSE PRACTITIONER
Kristin Huynh 615 N Michigan St 1st Flr, South Bend, IN 46601-1033 FAMILY PRACTICE
Angela Kay 615 N Michigan St 6, South Bend, IN 46601-1033 PHYSICIAN ASSISTANT
John Katsaropoulos 610 N Michigan St, South Bend, IN 46601-1081 INTERVENTIONAL CARDIOLOGY
Zdzislaw Kosel 615 N Michigan St, South Bend, IN 46601-1033 ANESTHESIOLOGY
Jacqueline Nuval 112 W Jefferson Blvd, South Bend, IN 46601-1921 CLINICAL PSYCHOLOGIST
Oluyinka Osunnuga 112 W Jefferson Blvd, South Bend, IN 46601-1921 NURSE PRACTITIONER
William Stonehill 707 N Michigan St, South Bend, IN 46601-1068 UROLOGY
Stacy Mc Dowell 615 N Michigan St 1st Flr, South Bend, IN 46601-1033 CLINICAL NURSE SPECIALIST
Cheryl Stahl 707 N Michigan St, South Bend, IN 46601-1068 NURSE PRACTITIONER
Matthew Folstein 621 Memorial Dr, South Bend, IN 46601-1064 GENERAL SURGERY
Wen Lum 615 N Michigan St 1st Floor, South Bend, IN 46601-1033 INTERNAL MEDICINE
Nicholas Datzman 615 N Michigan St, South Bend, IN 46601-1033 ANESTHESIOLOGY
Kean Kamman 615 N Michigan St, South Bend, IN 46601-1033 ANESTHESIOLOGY
Aaron Lewis 714 N Michigan St, South Bend, IN 46601-1035 FAMILY PRACTICE
James Strycker 714 N Michigan St, South Bend, IN 46601-1035 FAMILY PRACTICE
Stephen Kim 615 N Michigan, South Bend, IN 46601-1033 DIAGNOSTIC RADIOLOGY