Basic Information
Provider Information
NPI: 1245224526
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TOPER
FirstName: ZIYA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6301 UNIVERSITY COMMONS
Address2: SUITE 230
City: SOUTH BEND
State: IN
PostalCode: 466351571
CountryCode: US
TelephoneNumber: 5742512100
FaxNumber:  
Practice Location
Address1: 6301 UNIVERSITY COMMONS
Address2: SUITE 320
City: SOUTH BEND
State: IN
PostalCode: 466351571
CountryCode: US
TelephoneNumber: 5742717337
FaxNumber: 5743673733
Other Information
ProviderEnumerationDate: 09/01/2005
LastUpdateDate: 11/03/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X01052924AINY Allopathic & Osteopathic PhysiciansPediatrics 

ID Information
IDTypeStateIssuerDescription
200296490A05IN MEDICAID


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