| NPI | 1386917912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY DELAO Administrator 219-836-5800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02002075) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IN 01021975) |
| 207V00000X Obstetrics & Gynecology (Licence: IN 01027708) | |
| 208000000X Pediatrics (Licence: IN 01028626) | |
| Enumeration Date | 2012-02-13 |
| Last Update Date | 2012-03-28 |