Organization
INDIANA VASCULAR ASSOCIATES, LLC
Active
Other names
Lafayette Regional Vein & Laser Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARLIN WADE SCHUL MD, MBA, RVT, FACPH (PRESIDENT)
(765) 807-2770
Entity
Organization
Contact information
Practice address
3920 ST FRANCIS WAY, SUITE 105, LAFAYETTE, IN 47905-4917
(765) 807-2770
(765) 807-0348
Mailing address
3920 ST FRANCIS WAY, SUITE 105, LAFAYETTE, IN 47905-4917
(765) 807-2770
(765) 807-0348
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100379350
—
IN
01
—
11398636
CAQH
IN
Enumeration date
12/16/2013
Last updated
12/16/2013
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