| NPI | 1821007543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FADI ALZEIDAN Physician/Owner 219-769-6639 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01053003) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2020-08-22 |