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Individual

PAUL CHIKE OKOLOCHA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2054 GRANT ST, GARY, IN 46404-3060
(219) 949-7540
Mailing address
1314 FITZGERALD DR, MUNSTER, IN 46321-4204

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01041856
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000285585
BCBS
IN
05
100326100
IN
Enumeration date
03/20/2007
Last updated
07/08/2007
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