Healthcare Provider Details

I. General information

NPI: 1336195353
Provider Name (Legal Business Name): LUDAG LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8701 BROADWAY
MERRILLVILLE IN
46410-7035
US

IV. Provider business mailing address

8701 BROADWAY
MERRILLVILLE IN
46410-7035
US

V. Phone/Fax

Practice location:
  • Phone: 574-271-2558
  • Fax: 574-273-1137
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT T WOODBURN
Title or Position: OWNER
Credential: MD
Phone: 219-763-2246