Organization
NORTHERN INDIANA ONCOLOGY CENTER OF PORTER MEMORIAL HOSPITAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KOPPOLU P SARMA MD (SENIOR PARTNER)
(219) 462-8246
Entity
Organization
Contact information
Practice address
54 ROOSEVELT RD, VALPARAISO, IN 46383
(219) 462-8249
(219) 462-7902
Mailing address
DEPT 6064, CAROL STREAM, IL 60122-6064
(219) 462-8249
(219) 462-7902
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200009380A
—
IN
Enumeration date
05/26/2006
Last updated
08/02/2011
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