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Individual

CHARLES LEO TREMAINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1950 45TH AVE, SUITE 200, MUNSTER, IN 46321-3927
(219) 924-6544
(219) 922-8502
Mailing address
1950 45TH AVE, SUITE 200, MUNSTER, IN 46321-3927
(219) 924-6544
(219) 922-8502

Taxonomy

Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
01035537A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100202530A
IN
Enumeration date
11/28/2006
Last updated
06/23/2010
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