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 |