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JANIS C INGEBRIGTSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1530 N 7TH ST, SUITE 110, TERRE HAUTE, IN 47807-1057
(812) 238-7878
Mailing address
PO BOX 2505, INDIANAPOLIS, IN 46206-2505
(812) 238-7783
(812) 238-4506

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01041582
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080122269
RR MEDICARE
IN
05
200124870
IN
Enumeration date
11/02/2005
Last updated
10/18/2010
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