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Individual

REGINA M IWINSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1007 LINCOLNWAY, LA PORTE, IN 46352-0250
(219) 326-1234
Mailing address
75 REMIT DR, LOCKBOX 3309, CHICAGO, IL 60675-3309
(866) 915-5259
(231) 922-4030

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01046998A
IN
207P00000X
Emergency Medicine Physician
E0395
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200163490
IN
05
200163490A
IN
Enumeration date
07/13/2006
Last updated
04/03/2009
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