Organization
ST CLARE HEALTH NETWORK
Active
Parent organization
ST CLARE MEDICAL CENTER
Other names
Northridge Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST CLARE MEDICAL CENTER
Authorized official
JIM SIEMERS (EXECUTIVE DIRECTOR)
(765) 362-2800
Entity
Organization
Contact information
Practice address
1704 LAFAYETTE RD, CRAWFORDSVILLE, IN 47933-1071
(765) 364-1252
Mailing address
1710 LAFAYETTE RD, CRAWFORDSVILLE, IN 47933-1033
(765) 361-3012
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100389570A
—
IN
Enumeration date
11/21/2006
Last updated
07/24/2008
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