Individual
DIANA SHRADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
901 MACARTHUR BOULEVARD, MUNSTER, IN 46321-2901
(219) 836-1600
(219) 513-1127
Mailing address
901 MACARTHUR BOULEVARD, ANESTHESIA DEPARTMENT, MUNSTER, IN 46321-2901
(219) 836-7040
(219) 513-1127
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01052602A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000081323
ANTHEM BCBS
IN
01
—
7907386
AETNA
IN
Enumeration date
08/22/2006
Last updated
11/23/2007
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