Doctor Name: | DR. SHEILA MOTHKUR |
NPI Number: | 1235228818 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 01037546 |
Business Practice Address: | 1501 Wabash St Ste 101 Michigan City, IN - 463604364 |
Business Phone Number: | 2198745333 |
Business Fax Number: | 2198740254 |
Mailing Address: | 1501 Wabash St Ste 101, MICHIGAN CITY |
State: | IN |
Postal Code: | 463604364 |
Phone Number: | 2198745333 |
Fax Number: | 2198740254 |
NPI Enumeration Date: | 10/12/2006 |
NPI Last Update Date: | 12/15/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 01037546 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy 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. |