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Individual

ANEKAL B SREERAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
255 E 90TH DR, MERRILLVILLE, IN 46410-8144
(219) 795-1309
Mailing address
7891 BROADWAY STE A, MERRILLVILLE, IN 46410-5556
(219) 756-3988
(219) 756-2595

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01046404A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200158920C
IN
Enumeration date
10/22/2007
Last updated
04/14/2009
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