Individual provider · Type 1 NPI

Mitchell Daugherty

Sports Medicine (Family Medicine) Physician · South Bend, IN

NPI number 1417481540 Active

Practice location

1815 E Ireland Rd
South Bend, IN 46614-2845

Call (574) 647-1700 Map

Fax (574) 647-7572

Mailing address

710 N Niles Ave
South Bend, IN 46617-1924

Other practice locations

100 Navarre Pl Ste 4440, South Bend, IN 46601-1171 · (574) 647-5300
714 N Michigan St, South Bend, IN 46601-1035 · (574) 647-7477
900 I St, La Porte, IN 46350-5533 · (219) 324-1700
111 W Jefferson Blvd Ste 100, South Bend, IN 46601-1993 · (574) 647-1670

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician	207Q00000X	01082368A (IN)
Sports Medicine (Family Medicine) Physician Primary	207QS0010X	01082368A (IN)

Sports Medicine (Family Medicine) Physician: A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomecha…

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About NPI 1417481540

Mitchell Daugherty's National Provider Identifier is 1417481540, issued on Apr 14, 2017. The primary taxonomy on file is Sports Medicine (Family Medicine) Physician (207QS0010X), and the practice location is in South Bend, IN. The record was last updated on Jun 20, 2025.