Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 01042699 | IN |
NPI | 1285661439 |
---|---|
Provider Name | Dr. Rosalie L Mcbride |
First Address | Elkhart, IN 46514-1417 |
Second Address | Elkhart, IN 46514-1417 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000082178 | ANTHEM BLUE CROSS (01) | IN |
15836 | PHYSICIANS HEALTH PLAN (01) | IN |
200030450 | (05) | IN |
G02115 | (02) | IN |