| NPI | 1699225698 |
|---|---|
| Doing Business As | EDGEWATER PRIMARY CARE |
| Entity Type | Organization |
| Authorized Contact | DANITA JOHNSON HUGHES President/CEO 219-885-4264 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01033511A) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2016-10-13 |
| Last Update Date | 2024-11-22 |