Individual
DUSTIN T SIMCOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
401 NEWPORTE BLVD, LA PORTE, IN 46350-4099
(219) 575-6244
(219) 380-0757
Mailing address
2022 KELLE DR, CHESTERTON, IN 46304-8708
(219) 364-4004
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001987A
IN
363A00000X
Physician Assistant
—
—
Other
Enumeration date
11/03/2015
Last updated
06/03/2021
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