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1760476303
AUGUSTINE I IZAH
MERRILLVILLE, IN
NPI
1760476303
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: IN 01042994)
Enumeration Date
2005-09-09
Last Update Date
2009-11-17
Business Address
-- AUGUSTINE I IZAH MD
5857 BROADWAY
MERRILLVILLE, IN 46410-2666
Phone number: 219-884-4450
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Mailing Address
-- AUGUSTINE I IZAH MD
5857 BROADWAY
MERRILLVILLE, IN 46410-2666
Phone number: 219-884-4450
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