Individual
MARY O UBANWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3500 FRANCISCAN WAY, MICHIGAN CITY, IN 46360-0021
(219) 879-8511
(219) 877-2000
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01056232A
IN
208M00000X
Hospitalist Physician
Primary
01056232A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000722209
ANTHEM TRADITIONAL
IN
05
—
200396780
—
IN
01
—
616679523
DEPARTMENT OF LABOR
IN
01
—
P01050911
MEDICARE RR
IN
Enumeration date
07/25/2006
Last updated
10/09/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us