| NPI | 1225185739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J O'CONNELL Physician 574-287-7205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02000569A) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2011-01-21 |