Individual
DR. JAMES SIMANTIRAKIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
12800 MISSISSIPPI PKWY STE B201, CROWN POINT, IN 46307-6902
(219) 663-7000
(219) 663-8610
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
02002524
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000721930
ANTHEM TRADITIONAL
IN
05
—
200388630
—
IN
Enumeration date
06/27/2005
Last updated
09/25/2023
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