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General NPI Number Information
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NPI Number | 1093752610
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Entity Type | Organization
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Legal Business Name | MONROE MEDICAL ASSOCIATES, SC
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 10/07/2010
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Provider Practice Location Address
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Address Line | 801 MACARTHUR BLVD SUITE 401
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City | MUNSTER
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State | IN
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Zip | 46321-2915
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Country | US
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Telephone | 219-836-2860
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Fax |
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Provider Business Mailing Address
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Address Line | 801 MACARTHUR BLVD SUITE 401
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City | MUNSTER
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State | IN
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Zip | 46321-2915
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Country | US
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Telephone | 219-836-2860
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Fax |
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Authorized Official
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Title or Position | CEO / SENIOR PARTNER
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Name | MARK F KOZLOFF
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Credential | MD
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Telephone | 708-339-4800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 042003867
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License Number State | IL
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