| NPI | 1497172225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAIZUDDIN SHAREEF President 219-427-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2014-03-18 |
| Last Update Date | 2014-03-18 |