Organization
PORTAGE HEART CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABDUL KAWAMLEH MD (MD)
(219) 762-0400
Entity
Organization
Contact information
Practice address
6375 US HIGHWAY 6, SUITE B, PORTAGE, IN 46368
(219) 762-0400
(219) 762-2460
Mailing address
6375 US HIGHWAY 6, SUITE B, PORTAGE, IN 46368
(219) 762-0400
(219) 762-2460
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200293540A
—
IN
Enumeration date
07/05/2006
Last updated
10/21/2010
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