Individual
DR. DEBORAH L MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
6091 BROADWAY, MERRILLVILLE, IN 46410-2619
(219) 763-8113
Mailing address
PO BOX 1430, PORTAGE, IN 46368-9230
(219) 763-8112
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01026315A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000084532
ANTHEM
IN
05
—
100147650A
—
IN
Enumeration date
08/01/2006
Last updated
11/07/2012
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