Individual
DR. SARAH MELISSA AGBADA POLISTICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1509 STATE ST, LA PORTE, IN 46350-3115
(219) 324-3431
(219) 362-3802
Mailing address
2022 KELLE DR, CHESTERTON, IN 46304-8708
(219) 364-4004
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01085776A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/01/2019
Last updated
09/14/2021
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