Individual
MIGUEL ANGEL PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
770 INDIANA BOUNDARY RD STE 203, CHESTERTON, IN 46304-1519
(219) 921-2059
(219) 395-8990
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01069687A
IN
207Q00000X
Family Medicine Physician
036130512
IL
Other
Enumeration date
07/10/2007
Last updated
08/17/2023
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