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Individual

MARY BETH LODATO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CERTIFIED NURSE MIDW

Contact information

Practice address
316 CHANDLER AVE, EVANSVILLE, IN 47713
(812) 436-4501
(812) 436-4510
Mailing address
PO BOX 3407, EVANSVILLE, IN 47733-3407
(812) 450-3363
(812) 450-3071

Taxonomy

Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
72000026A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000328977
ANTHEM BC/BS
01
11384964
CAQH PROVIDER ID
05
200188920
IN
05
200188920A
IN
01
351791786109
CARESOURCE PROVIDER ID
IN
Enumeration date
07/20/2005
Last updated
05/30/2018
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