| NPI | 1669651105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESE A HINES Billing Supervisor 219-769-4616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01025043A) |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2007-11-01 |