Organization
NORTHWEST INDIANA RADIATION ONCOLOGY GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KOPPOLU P SARMA MD (MEDICAL DIRECTOR)
(219) 942-5745
Entity
Organization
Contact information
Practice address
300 W 61ST AVE, HOBART, IN 46342-6490
(219) 942-5745
(219) 462-7902
Mailing address
PO BOX 660408, INDIANAPOLIS, IN 46266-0408
(219) 942-5745
(219) 462-7902
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
08/05/2011
Last updated
11/17/2011
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