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General NPI Number Information
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NPI Number | 1710244686
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Entity Type | Organization
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Legal Business Name | FAMILY HEALTH CARE INC
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Dates
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Enumeration Date | 04/17/2012
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 6111 HARRISON ST STE 380
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City | MERRILLVILLE
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State | IN
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Zip | 46410-2972
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Country | US
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Telephone | 219-942-4222
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Fax | 219-942-4233
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Provider Business Mailing Address
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Address Line | 6111 HARRISON ST STE 380
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City | MERRILLVILLE
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State | IN
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Zip | 46410-2972
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Country | US
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Telephone | 219-942-4222
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Fax | 219-942-4233
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Authorized Official
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Title or Position | OWNER
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Name | MS. MUTENA B. KORMAN
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Credential | MD
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Telephone | 219-942-4222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 200402440
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License Number State | IN
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