Organization
CROSSROADS MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTINE S BERGERON (PRESIDENT)
(219) 756-6600
Entity
Organization
Contact information
Practice address
403 W 81ST AVE, MERRILLVILLE, IN 46410-5317
(219) 756-6600
(219) 756-6602
Mailing address
403 W 81ST AVE, MERRILLVILLE, IN 46410-5317
(219) 756-6600
(219) 756-6602
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Enumeration date
11/17/2009
Last updated
11/17/2009
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