Individual
DR. AUSTIN WADE PULLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 EAST BLVD, ELKHART, IN 46514-2483
(574) 523-3193
Mailing address
1513 E JACKSON BLVD, ELKHART, IN 46516-4405
(574) 523-3193
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01080285A
IN
390200000X
Student in an Organized Health Care Education/Training Program
4301111932
MI
Other
Enumeration date
04/25/2013
Last updated
05/01/2018
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