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Individual

GRACE ESAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2522 WATERBRIDGE WAY, EVANSVILLE, IN 47710-3200
(812) 422-6886
(812) 428-5508
Mailing address
2522 WATERBRIDGE WAY, EVANSVILLE, IN 47710-3200

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01056843
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200405340
IN
Enumeration date
09/15/2005
Last updated
06/20/2022
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