Individual
MARY BARBARA BACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
301 WILLOW BEND DR, LA PORTE, IN 46350
(219) 362-3681
(219) 324-4343
Mailing address
301 WILLOW BEND DR, LA PORTE, IN 46350
(219) 362-3681
(219) 324-4343
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01017394A
IN
Other
Enumeration date
10/20/2009
Last updated
10/20/2009
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