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General NPI Number Information
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NPI Number | 1942313366
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Entity Type | Individual
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Provider Name | DOUGE BARTHELEMY M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 11/25/2020
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Provider Practice Location Address
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Address Line | 720 W 5TH AVE GARY
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City | GARY
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State | IN
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Zip | 46402-1808
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Country | US
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Telephone | 219-882-0262
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Fax | 219-882-0515
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Provider Business Mailing Address
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Address Line | 1015 N SHELBY ST GARY
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City | GARY
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State | IN
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Zip | 46403-1446
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Country | US
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Telephone | 219-938-0920
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Fax | 219-938-0923
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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