St. Mary Medical Center INC
Family Medicine in Merrillville, IN. Organization (NPI-2).
NPI number1598839730
StatusActive
Last updated in NPPESJul 11, 2024
Details
- NPI
- 1598839730
- Entity type
- Organization (NPI-2)
- Legal business name
- St. Mary Medical Center INC
- Organization subpart
- Yes
- Enumeration date
- Nov 20, 2006
- Certification date
- Jul 11, 2024
- Last updated
- Jul 11, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Other names
- Michael Kovacich MD (Doing Business As)
Practice location
200 E 80th PlaceSte 100
Merrillville, IN 46410-5671
Phone 219-769-7536 · Fax 219-736-1506
Mailing address
9660 Wicker AvenueSt John, IN 46373-9487
Phone 219-226-2203 · Fax 219-226-2202
Authorized official
Janice Ryba
Ceo
2199420551
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