Individual
EMMANUEL N ESPINOSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
PO BOX 4780, BLOOMINGTON, IN 47402-4780
(812) 336-1690
(812) 349-1311
Mailing address
PO BOX 4780, BLOOMINGTON, IN 47402-4780
(812) 336-1690
(812) 349-1311
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01072093A
IN
207Q00000X
Family Medicine Physician
4301063022
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0804112811
BLUE CROSS BLUE SHIELD
—
Enumeration date
05/31/2005
Last updated
01/02/2025
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