Individual
MICHAEL ALLAN STREETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1201 S MAIN ST, CROWN POINT, IN 46307-8481
(219) 757-6310
Mailing address
1040 SIERRA DR, SUITE 400, GREENWOOD, IN 46143-7241
(317) 528-4252
(317) 865-8318
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
02003350A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000722408
ANTHEM TRADITIONAL
IN
05
—
200926260
—
IN
Enumeration date
11/21/2008
Last updated
05/17/2012
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