Organization
PORTER NEONATAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSARIO CHUA MD (PRESIDENT)
(765) 446-9600
Entity
Organization
Contact information
Practice address
814 LAPORTE AVE, VALPARAISO, IN 46383-5860
(219) 263-4600
Mailing address
2304 KOSSUTH ST, LAFAYETTE, IN 47904-3240
(765) 446-9600
(765) 446-1100
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201016330A
—
IN
Enumeration date
04/04/2011
Last updated
05/25/2011
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