Individual
ELIZABETH B GINGRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
206 W. WARREN ST, MIDDLEBURY, IN 46540-0459
(574) 825-2146
(574) 825-2182
Mailing address
PO BOX 459, MIDDLEBURY, IN 46540-0459
(574) 825-2146
(574) 825-2146
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01043636A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080149881
R/R MEDICARE
IN
05
—
200066650A
—
IN
05
—
200066650B
—
IN
Enumeration date
07/24/2006
Last updated
01/27/2010
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