Individual
KIMBERLY L. PLOEHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10215 BROADWAY FL 1, CROWN POINT, IN 46307-8001
(219) 661-6098
(219) 703-6812
Mailing address
8558 BROADWAY, MERRILLVILLE, IN 46410-7032
(219) 392-7084
(219) 703-6854
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01094884A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104457857
ANTHEM
IN
05
—
300096697
—
IN
05
—
3084194
—
MI
Enumeration date
08/03/2006
Last updated
11/01/2024
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