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Individual

DR. AOKO DORIS CRAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
615 N MICHIGAN ST, SOUTH BEND, IN 46601-1033
(574) 647-7459
(574) 647-3658
Mailing address
615 N MICHIGAN ST, SOUTH BEND, IN 46601-1033
(574) 647-7167
(574) 647-3671

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01076165A
IN
207P00000X
Emergency Medicine Physician
125-063112
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000001024836
ANTHEM
IN
05
201367630
IN
Enumeration date
06/14/2013
Last updated
08/10/2016
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