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Organization

TEAM PHYSICIANS OF INDIANA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BENOIT O CHOINIERE (PRESIDENT)
(219) 756-6600
Entity
Organization

Contact information

Practice address
403 W 81ST AVE, MERRILLVILLE, IN 46410-5317
(219) 756-6600
(219) 756-6602
Mailing address
403 W 81ST AVE, MERRILLVILLE, IN 46410-5317
(219) 756-6600
(219) 756-6602

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
IN
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000387968
BC/BS GROUP NUMBER
IN
Enumeration date
08/09/2006
Last updated
08/23/2007
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