Organization
REDDY RHEUMATOLOGY OF NORTHWEST IN PC
Active
Organization
REDDY RHEUMATOLOGY OF NORTHWEST IN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JUDITH ANNE LONGACRE (ADMINISTRATIVE ASSISTANT)
(219) 736-2922
Entity
Organization
Contact information
Practice address
118 E 90TH DRIVE, MERRILLVILLE, IN 46410-7160
(219) 736-2922
(219) 736-2938
Mailing address
118 E 90TH DRIVE, MERRILLVILLE, IN 46410-7160
(219) 736-2922
(219) 736-2938
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
01056231A
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000322080
ANTHEM
IN
05
—
200806960
—
IN
01
—
P00173282
RAILROAD MEDICARE
IN
Enumeration date
11/09/2007
Last updated
11/11/2009
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