Individual
GEORGE BABCHUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12800 MISSISSIPPI ST, SUITE B201, CROWN POINT, IN 46307-6900
(219) 663-7000
(219) 663-8621
Mailing address
1040 SIERRA DR, SUITE 400, GREENWOOD, IN 46143-7241
(317) 528-4252
(317) 865-8318
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01031717
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000721904
ANTHEM TRADITIONAL
IN
05
—
100463680
—
IN
Enumeration date
06/09/2005
Last updated
05/14/2012
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