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Individual

SUSAN H BANTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
911 N CENTRAL AVE, CONNERSVILLE, IN 47331-2051
(765) 827-1164
(765) 827-3876
Mailing address
509 HARCOURT WAY, PO BOX 21, RUSHVILLE, IN 46173
(765) 932-3699
(765) 932-4164

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01049721A
IN

Other

Enumeration date
07/24/2006
Last updated
07/08/2007
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