Organization
THYROID & DIABETES MANAGEMENT CENTER LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD LONGLEY M.D. (PRESIDENT)
(219) 836-2022
Entity
Organization
Contact information
Practice address
8939 BROADWAY, MERRILLVILLE, IN 46410-7039
(219) 836-2022
Mailing address
9201 CALUMET AVE, MUNSTER, IN 46321-2807
(219) 836-2022
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100215590
—
IN
Enumeration date
08/08/2006
Last updated
10/06/2010
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