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Individual

KUNTEERA TARIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
11275 DELAWARE PKWY, CROWN POINT, IN 46307-7812
(219) 779-8735
(877) 715-2312
Mailing address
PO BOX 108, CROWN POINT, IN 46308-0108
(219) 779-8735
(877) 715-2312

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01064237A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000722745
ANTHEM TRADITIONAL
IN
05
200950380
IN
Enumeration date
07/30/2009
Last updated
03/25/2019
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