Dedelow, Douglas C

Dedelow, Douglas C is an individual health care provider with primary practice located at 1400 S Lake Park Ave Ste 205, Hobart IN 46342-6790. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Dedelow, Douglas C can be contacted via phone (219) 942-8620.

Contact Information

Primary practice address
1400 S Lake Park Ave Ste 205 Hobart IN 46342-6790
Phone: (219) 942-8620
Fax: (219) 942-6356
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 02001822A Indiana

Profile Details

NPI number 1861492993
LBN Legal business name Dedelow, Douglas C
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2005
Last updated Jul 29th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861492993 NPPES
Indiana MEDICAID 200127880
Indiana Other 256700A

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