Organization
LINCOLN PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADAM SERGIWA MD (CEO)
(219) 326-5400
Entity
Organization
Contact information
Practice address
414 LINCOLNWAY, LA PORTE, IN 46350-3350
(219) 326-5400
(219) 326-5455
Mailing address
PO BOX 785, LA PORTE, IN 46352-0785
(219) 326-5400
(219) 326-5455
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01049378A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000305691
ANTHEM BC/BS
IN
05
—
200199090A
—
IN
Enumeration date
11/17/2008
Last updated
10/05/2011
Update your record
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