Organization
INDIANA PHYSICIAN MANAGEMENT-RANDOLPH, 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
473 E GREENVILLE AVE, WINCHESTER, IN 47394-9436
(317) 870-0480
(317) 870-0499
Mailing address
7148 SOLUTION CTR, CHICAGO, IL 60677-7001
(317) 870-6763
(317) 870-0499
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201037180B
—
IN
Enumeration date
10/24/2011
Last updated
01/11/2013
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