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Individual

RAQUEL ELISA REDONDO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
701 SUPERIOR AVE STE 2500, MUNSTER, IN 46321-4037
(219) 934-9852
(815) 836-7593
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01080526A
IN
208600000X
Surgery Physician
D81389
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
109547100
MD
Enumeration date
06/14/2011
Last updated
05/06/2026
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