Individual
DR. LYLE R MUNN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1190 N STATE ROAD 49, PORTER, IN 46304-1368
(219) 926-2146
(219) 926-3721
Mailing address
1190 N STATE ROAD 49, PORTER, IN 46304-1368
(219) 926-2146
(219) 926-3721
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
01031582
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000214506
BCBS PROVIDER NUMBER
IN
Enumeration date
07/20/2005
Last updated
07/08/2007
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