Individual
DR. EDITH M CULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2310 CALIFORNIA RD, ELKHART, IN 46514-1228
(574) 264-4163
(574) 262-9650
Mailing address
2310 CALIFORNIA RD, ELKHART, IN 46514-1228
(574) 264-4163
(574) 262-9650
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
01061215A
IN
208D00000X
General Practice Physician
01061215A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201092890
—
IN
Enumeration date
09/19/2005
Last updated
10/23/2013
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