Organization
GLHS ANESTHESIA GROUP
Active
Organization
GLHS ANESTHESIA GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA THOMAS PHALEN (DIRECTOR)
(219) 554-4548
Entity
Organization
Contact information
Practice address
1701 S CREASY LN, LAFAYETTE, IN 47905-4972
(765) 502-4917
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200520240A
—
IN
05
—
200520240B
—
IN
05
—
300029249
—
IN
05
—
300029746
—
IN
Enumeration date
08/07/2006
Last updated
02/15/2023
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