Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 01046299A | IN |
NPI | 1134106347 |
---|---|
Provider Name | Dr. Joseph B Landwehr JR. |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Muncie, IN 47304-3988 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2005 |
Last Update Date | 30/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000304612 | ANTHEM (01) | IN |
200133000A | (05) | IN |
G13940 | (02) | IN |