Individual
MARY J BALADAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
7905 CALUMET AVE, MUNSTER, IN 46321-2549
(219) 836-5800
(219) 836-3048
Mailing address
1040 SIERRA DR STE 400, GREENWOOD, IN 46143-7241
(317) 528-4800
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
02001844A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200171740
—
IN
Enumeration date
06/10/2006
Last updated
03/13/2021
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