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Special Medicine Clinic
Specialist in Michigan City, Indiana
NPI 1962640821

Special Medicine Clinic is a Specialist based in Michigan City, IN. Special Medicine Clinic practices in Michigan City, IN. The NPI Number for Special Medicine Clinic is 1962640821 and holds a License No. 01029292A (Indiana).

The current practice location address for Special Medicine Clinic is 1501 Wabash St Ste 303, Michigan City, IN and can be reached out via phone at 219-874-8711 and via fax at 219-874-9075.

Location: 1501 Wabash St Ste 303, Michigan City, IN, 46360-4355
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1962640821
Provider Name
Special Medicine Clinic
Credential
Provider Entity Type
Organization
Address
1501 Wabash St Ste 303, Michigan City, IN, 46360-4355
Phone Number
219-874-8711
Fax Number
219-874-9075
Provider Enumeration Date
01/30/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000000111817 01 KY BLUE CROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
1501 Wabash St Ste 303
City
Michigan City
State
Indiana
Zip
46360-4355
Phone Number
219-874-8711
Fax Number
219-874-9075
person
Provider Business Mailing Address Details
Address
1501 Wabash St Ste 303
City
Michigan City
State
Indiana
Zip
46360-4355
Phone Number
219-874-8711
Fax Number
219-874-9075
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
01029292A (Indiana)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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