Doctor Name: | DR. EDITH M CULLEN |
NPI Number: | 1720073521 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 01061215A |
Business Practice Address: | 2310 California Rd Elkhart, IN - 465141228 |
Business Phone Number: | 5742644163 |
Business Fax Number: | 5742629650 |
Mailing Address: | 2310 California Rd, ELKHART |
State: | IN |
Postal Code: | 465141228 |
Phone Number: | 5742644163 |
Fax Number: | 5742629650 |
NPI Enumeration Date: | 09/19/2005 |
NPI Last Update Date: | 10/23/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 01061215A |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |