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Individual

MR. JOEL DOUGLAS BATES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1001 STURDY RD, VALPARAISO, IN 46383-4126
(219) 462-7173
(219) 462-7504
Mailing address
1001 STURDY RD, VALPARAISO, IN 46383-4126
(219) 462-7173
(219) 462-7504

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02006581A
IN
207Q00000X
Family Medicine Physician
5101013835
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1285738435
MI
05
300057704
IN
05
4750822-11
MI
Enumeration date
09/09/2006
Last updated
02/12/2024
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