Individual
DR. SAMARA ELLEN KESTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
814 LAPORTE AVE, VALPARAISO, IN 46383-5860
(219) 263-4600
Mailing address
1155 W 3RD ST, BLOOMINGTON, IN 47404-5016
(812) 336-1690
(812) 349-1311
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
02001380A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000615411
BLUE CROSS BLUE SHIELD
IN
01
—
02001380A
IN LICENSE
IN
01
—
02001380B
CSR
IN
05
—
100331070
—
IN
Enumeration date
08/31/2006
Last updated
03/07/2023
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