Organization
CHARISM CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CYNTHIA SPELLMAN M.D. (MEDICAL DIRECTOR)
(574) 753-8000
Entity
Organization
Contact information
Practice address
101 E MARKET ST, LOGANSPORT, IN 46947-3427
(574) 753-8000
(574) 753-8003
Mailing address
101 E MARKET ST, LOGANSPORT, IN 46947-3427
(574) 753-8000
(574) 753-8003
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01057949A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000386275
ANTHEM
IN
Enumeration date
06/19/2007
Last updated
08/31/2007
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