Individual
MICHAEL BRODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
901 MACARTHUR BLVD, ANESTHESIA DEPARTMENT, MUNSTER, IN 46321-2901
(219) 836-1600
(219) 513-1127
Mailing address
901 MACARTHUR BLVD, ANESTHESIA DEPARTMENT, MUNSTER, IN 46321-2901
(219) 836-7040
(219) 513-1127
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01051737A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000081297
ANTHEM BCBS
IN
05
—
036093177
—
IL
05
—
200251390A
—
IN
Enumeration date
05/08/2006
Last updated
06/16/2010
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