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General NPI Number Information
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NPI Number | 1104076306
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Entity Type | Organization
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Legal Business Name | PROCARE MEDICAL LLC
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Dates
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Enumeration Date | 09/24/2008
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Last Update Date | 12/04/2009
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Provider Practice Location Address
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Address Line | 2723 S 7TH ST STE A
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City | TERRE HAUTE
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State | IN
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Zip | 47802-3558
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Country | US
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Telephone | 812-238-1730
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Fax | 812-242-1565
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Provider Business Mailing Address
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Address Line | 2723 S 7TH ST STE A
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City | TERRE HAUTE
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State | IN
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Zip | 47802-3558
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Country | US
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Telephone | 812-238-1730
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Fax | 812-242-1565
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Authorized Official
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Title or Position | MEMBER
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Name | DR. GEORGE B BITTAR
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Credential | M.D.
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Telephone | 812-232-8164
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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