Organization
INDIANA PHYSICIAN MANAGEMENT-LOGANSPORT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEWART BICK M.D. (PRESIDENT)
(317) 338-5053
Entity
Organization
Contact information
Practice address
1101 MICHIGAN AVE, LOGANSPORT, IN 46947-1528
(317) 870-0480
(317) 870-0499
Mailing address
7166 SOLUTION CTR, CHICAGO, IL 60677-0001
(317) 870-6752
(317) 870-0499
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201040470A
—
IN
Enumeration date
10/24/2011
Last updated
01/11/2013
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