Organization
MEDICAL CLINIC OF GREENSBURG
Active
Organization
MEDICAL CLINIC OF GREENSBURG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MUSTAFA REHAB MD (OWNER)
(812) 662-8699
Entity
Organization
Contact information
Practice address
203 EAST NORTH STREET, GREESNBURG, IN 46240
(812) 662-8699
Mailing address
203 E NORTH ST, GREENSBURG, IN 47240-1717
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01051524
IN
207RA0401X
Addiction Medicine (Internal Medicine) Physician
01051524
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200323770A
—
IN
Enumeration date
07/20/2007
Last updated
06/23/2008
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