Individual
MRS. MARY ROSE MCCULLOUGH
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
955 N MICHIGAN AVE, GREENSBURG, IN 47240-1487
(812) 663-7277
(812) 662-7307
Mailing address
955 N MICHIGAN AVE, GREENSBURG, IN 47240-1487
(812) 663-7277
(812) 662-7307
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01032780A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181030
—
IN
Enumeration date
07/18/2005
Last updated
07/08/2007
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