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General NPI Number Information
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NPI Number | 1417831702
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Entity Type | Organization
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Legal Business Name | ORTHOPEDIC MEDICAL DEVELOPMENT, LLC
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Dates
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Enumeration Date | 08/01/2025
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 201 E 101ST AVE
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City | CROWN POINT
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State | IN
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Zip | 46307
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Country | US
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Telephone | 219-661-6018
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Fax | 219-703-6623
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Provider Business Mailing Address
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Address Line | PO BOX 3064
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City | MUNSTER
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State | IN
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Zip | 46321-0064
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Country | US
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Telephone | 219-934-8888
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Fax | 219-934-8889
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Authorized Official
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Title or Position | DIRECTOR PFS
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Name | MS. CHAR KULLERSTRAND
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Credential |
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Telephone | 219-934-8888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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