Organization
LUDAG LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT T WOODBURN III MD (PRESIDENT)
(219) 739-5598
Entity
Organization
Contact information
Practice address
600 GRANT ST, GARY, IN 46402-6001
(219) 739-5598
Mailing address
PO BOX 85327, CHICAGO, IL 60689-5327
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100360170
—
IN
01
—
DA3166
RAIL ROAD MEDICARE GROUP
IN
Enumeration date
09/29/2006
Last updated
01/12/2024
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