Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Michiana Spine, Sports & Occupational Rehab, PC

Organization Pain Medicine (Physical Medicine & Rehabilitation) Physician · NPI 1912074659

Michiana Spine, Sports & Occupational Rehab, PC is a Pain Medicine (Physical Medicine & Rehabilitation) Physician in Mishawaka, Indiana. Licensed in Indiana. Registered with an NPI since 2006.

Licensed in
IN
In the registry since
2006
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

3740 Edison Lakes Pkwy
Mishawaka, IN 46545-3474
Phone: (574) 252-4150
Fax: (574) 252-4159
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pain Medicine (Physical Medicine & Rehabilitation) Physician (primary) Taxonomy 2081P2900X · Licence 01042863 (IN)

Record details

NPI number1912074659
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kevin Drew — President · (574) 252-4150
NPI enumeratedNovember 29, 2006
Last updated in NPPESNovember 3, 2022
Certification dateNovember 3, 2022
Mailing address3740 Edison Lakes Pkwy, Mishawaka, IN 46545-3474

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