| NPI | 1174851885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTH H BAKER Billing Manager 219-934-9399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: IN 01027712A) |
| Additional Taxonomies | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: IN 01027712A) |
| Enumeration Date | 2009-11-19 |
| Last Update Date | 2009-12-21 |