Individual
KRISTA M MOLINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
770 INDIAN BOUNDARY RD STE 200, CHESTERTON, IN 46304-1519
(219) 921-2000
(219) 395-8770
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01065580A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000661424
ANTHEM
IN
05
—
200916940
—
IN
Enumeration date
06/20/2007
Last updated
07/25/2023
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