NPI | 1407428519 |
---|---|
Entity Type | Organization |
Authorized Contact | CHERYL ANNETTE WATHEN Credentialing Specialist 812-450-3296 |
Organization Subpart ? | No |
Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology |
363A00000X Physician Assistant | |
363L00000X Nurse Practitioner | |
Enumeration Date | 2021-07-16 |
Last Update Date | 2024-09-30 |