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Individual

DR. DOUGE BARTHELEMY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
720 W 5TH AVE, GARY, GARY, IN 46402-1808
(219) 882-0262
(219) 882-0515
Mailing address
1015 N SHELBY ST, GARY, GARY, IN 46403-1446
(219) 938-0920
(219) 938-0923

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000082703
ANTHEM PROVIDER ID NO.
IN
05
100160510
IN
05
200505380
IN
Enumeration date
08/17/2006
Last updated
11/25/2020
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