Individual
JOHN STEVEN MIDMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3156 WILLOWCREEK RD, PORTAGE, IN 46368
(219) 548-5999
Mailing address
PO BOX 1873, VALPARAISO, IN 46384-1873
(219) 476-0352
(219) 531-0859
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
01040887A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100340370B
—
IN
01
—
P00092669
RR MCR
IN
Enumeration date
01/30/2006
Last updated
10/10/2014
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