| JM Weida MD CJ Sondgerath MD | |
|
3005 Greenbush St Lafayette IN 47904-2435 | |
| (765) 447-3103 | |
| (765) 449-4782 |
| Full Name | JM Weida MD CJ Sondgerath MD |
|---|---|
| Speciality | Family Medicine |
| Location | 3005 Greenbush St, Lafayette, Indiana |
| Authorized Official Name and Position | Laura Jane Odle (INSURANCE SPECIALIST) |
| Authorized Official Contact | 7654473103 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| JM Weida MD CJ Sondgerath MD 3005 Greenbush St Lafayette IN 47904-2435 Ph: (765) 447-3103 | JM Weida MD CJ Sondgerath MD 3005 Greenbush St Lafayette IN 47904-2435 Ph: (765) 447-3103 |
| NPI Number | 1629275243 |
|---|---|
| Provider Enumeration Date | 06/28/2007 |
| Last Update Date | 05/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629275243 | NPI | - | NPPES |
| 000000375905 | Other | IN | GROUP ANTHEM NUMBER |
| 200325640A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Indiana) | Primary |
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