Organization
CLINICAL COLLEAGUES OF INDIANA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KURT ZUMWALT (PRESIDENT)
(410) 429-6115
Entity
Organization
Contact information
Practice address
500 ARCADE AVE STE 100, ELKHART, IN 46514-2478
(800) 927-0002
(603) 893-8886
Mailing address
1765 E NINE MILE RD STE 1-229, PENSACOLA, FL 32514-5479
(410) 429-6115
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
07/24/2019
Last updated
02/21/2020
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