| NPI | 1427081090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL E. BRODERICK President 765-342-3686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: IN 50003439a) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2010-11-11 |