Medical school: CREIGHTON UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1985
NPI: 1124108303
Practice Locations (2)
LUTHERAN MEDICAL GROUP LLC
7950 W JEFFERSON BLVD, LUTHERAN HOSPITAL
FORT WAYNE, IN 468044140
2604357001
SOUTHEASTERN REGIONAL PHYSICIAN SERVICES
2936 N ELM ST, SUITE 102
LUMBERTON, NC 283582981
9106716619
Source: CMS National Downloadable File, September 2026.