St Joseph Medical Group INC

NPI #1801851902 in Angola, Indiana

Provider Information

NPI Number
1801851902
Entity Type
Organization
Organization Name
St Joseph Medical Group INC
Primary Specialty
Family Medicine
Enumeration Date
Apr 20, 2006
Last Updated
Jun 25, 2008

Practice Location

Address
1109 W MAUMEE ST
City
Angola
State
Indiana
ZIP Code
46703-1329
Phone
(260) 665-2131

Authorized Official

Name
DEBBIE T BREWER
Title
DIRECTOR OF PROVIDER ENROLLMENT
Phone
(615) 465-7626

Specialties & Taxonomy Codes

Specialty
General Practice
Nurse Practitioner
Family Medicine

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