Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 01028396 | IN |
NPI | 1063472124 |
---|---|
Provider Name | John M Adlard |
First Address | Munster, IN 46321-2911 |
Second Address | Munster, IN 46321-2893 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2006 |
Last Update Date | 09/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100188420A | (05) | IN |
B29093 | (02) |