Individual
DR. MICHELLE SRISUWANANUKORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9030 COLUMBIA AVE STE B, MUNSTER, IN 46321-2905
(219) 836-6002
Mailing address
9030 COLUMBIA AVE, MUNSTER, IN 46321
(219) 836-6002
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125059528
IL
207RG0100X
Gastroenterology Physician
Primary
01078489A
IN
Other
Enumeration date
06/08/2011
Last updated
07/21/2022
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