Organization
SOUTHLAKE INTERNAL MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHOAIB H RASHEED MD (OWNER)
(219) 252-0309
Entity
Organization
Contact information
Practice address
928 MARY ELLEN DR, CROWN POINT, IN 46307-8998
(219) 252-0309
Mailing address
928 MARY ELLEN DR, CROWN POINT, IN 46307-8998
(219) 252-0309
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01066300
IN
Other
Enumeration date
04/05/2017
Last updated
04/05/2017
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