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Individual

NANA N KORSAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1201 S MAIN ST, CROWN POINT, IN 46307-8481
(219) 757-6390
(219) 757-6336
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
57008787
OH
207RN0300X
Nephrology Physician
01069045A
IN
208M00000X
Hospitalist Physician
Primary
01069045A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000940579
ANTHEM PROVIDER NUMBER
IN
01
000000991160
ANTHEM PIN
IN
05
201002940
IN
Enumeration date
06/05/2007
Last updated
03/17/2018
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