NPI | 1093188229 |
---|---|
Entity Type | Organization |
Authorized Contact | DONNA PHALEN Director 219-554-4548 |
Organization Subpart ? | No |
Primary Taxonomy | 213E00000X Podiatrist |
Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease |
207RR0500X Internal Medicine, Rheumatology | |
207Q00000X Family Medicine | |
208000000X Pediatrics | |
208600000X Surgery | |
Enumeration Date | 2015-11-10 |
Last Update Date | 2023-02-13 |