| NPI | 1497954390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAZEERULLA SHAIK Physician 219-838-0066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: IN 010226043) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2018-12-10 |