Individual
RICARDO MANUEL QUEZADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
761 45TH AVE, STE. 103, MUNSTER, IN 46321-2893
(219) 922-3002
(219) 922-3003
Mailing address
757 45TH AVE, STE. 201, MUNSTER, IN 46321-2911
(219) 993-4246
(219) 934-2478
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25794
OK
207RI0200X
Infectious Disease Physician
Primary
01073108A
IN
Other
Enumeration date
08/09/2007
Last updated
08/28/2013
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