Edison Lakes Urology Plymouth Office

NPI 1033388558 - Urology - 208800000X

NPI Details
NPI 1033388558
Enumeration Date 02/28/2008
Last Updated 05/30/2008
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name DARRYL R DARRYL
Position EXECUTIVE ADMINISTRATOR
Phone (574) 935-2138
Fax (574) 935-2136
Practice Location
1919 LAKE AVE
SUITE 109
PLYMOUTH IN, 46563-7830, US
Phone (574) 935-2138
Fax (574) 935-2136
Business Location
303 S NAPPANEE ST
ELKHART IN, 46514-2066, US
Phone (574) 296-3200
Fax (574) 296-3300
Toxanomy
Taxonomy Code 208800000X
License State
License Number
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According to our database, Edison Lakes Urology Plymouth Office NPI is 1033388558, taxonomy code is 208800000X Edison Lakes Urology Plymouth Office physically located at 1919 Lake Ave, Plymouth IN, 46563-7830. NPI Number 1033115704 has the healthcare provider type.

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1033388558 NPI number is provided on an as is basis without warranty of any kind. 1033388558 is maintained by the National Plan & Provider Enumeration System. The contents of Edison Lakes Urology Plymouth Office are for informational purposes only.