Individual
DR. KATHRYN LAINE DEMITRUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
615 N MICHIGAN ST 1ST FL HOSPITALIST STE, SOUTH BEND, IN 46601-1033
(574) 647-3050
(574) 647-1094
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
(574) 647-2129
(217) 224-7950
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01091754A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300083376
—
IN
Enumeration date
06/18/2018
Last updated
12/05/2023
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