| NPI | 1558309492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN NICOLE LONG Insurance Administrator Co Office 219-362-4690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: IN 01052711A) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2020-08-22 |