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1821059148
DONALD SQUIRES DUNEVANT
PORTAGE, IN
NPI
1821059148
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: IN 01033863)
Enumeration Date
2006-03-28
Last Update Date
2019-05-16
Business Address
DONALD SQUIRES DUNEVANT MD
3630 WILLOWCREEK RD
PORTAGE, IN 46368-5075
Phone number: 219-759-5791
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Mailing Address
DONALD SQUIRES DUNEVANT MD
3630 WILLOWCREEK RD
PORTAGE, IN 46368-5075
Phone number: 219-759-1157
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