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Organization

ELITE INTERNAL MEDICINE PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. RAENETTE NAPIER (OFFICE MANAGER)
(219) 769-3550
Entity
Organization

Contact information

Practice address
1242 SURREY CT, CROWN POINT, IN 46307-5239
(219) 769-3550
(219) 769-2642
Mailing address
PO BOX 438, CROWN POINT, IN 46308-0438
(219) 769-3550
(219) 769-2642

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01034369A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200901600A
IN
Enumeration date
06/14/2008
Last updated
12/05/2012
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