Organization
NEW BALANCE OCCUPATIONAL MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ORANU G IBEKIE (MD)
(219) 769-4400
Entity
Organization
Contact information
Practice address
1574 E 85TH AVE, MERRILLVILLE, IN 46410
(219) 769-4400
(219) 795-1419
Mailing address
PO BOX 10746, MERRILLVILLE, IN 46411-0746
(219) 769-4400
(219) 795-1419
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
IN
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
2083X0100X
Occupational Medicine Physician
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201016650A
—
IN
Enumeration date
02/18/2011
Last updated
04/24/2019
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