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Individual

HOWARD D DETWEILER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
N. P.

Contact information

Practice address
5604 E WHITE OAK LN, MARENGO, IN 47140-8413
(812) 365-3221
(812) 365-9502
Mailing address
420 W LONGEST ST, PO BOX 270, PAOLI, IN 47454-8821
(812) 723-3944
(812) 723-5292

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
71000802A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200000890A
IN
Enumeration date
08/30/2006
Last updated
06/20/2011
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