Individual provider · NPI-1

Crisostomo J Carlos, MD

Thoracic Surgery (Cardiothoracic Vascular Surgery) · Munster, IN

NPI number1790700573
StatusActive
Last updated in NPPESJan 10, 2017

Details

NPI
1790700573
Entity type
Individual (NPI-1)
Name
Crisostomo J Carlos
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Jul 13, 2006
Last updated
Jan 10, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery)01026571AINYes

Practice location

801 Macarthur Blvd
Suite 305
Munster, IN 46321-2915

Phone 219-703-2401 · Fax 219-703-6687

Mailing address

801 Macarthur Blvd
Suite 305
Munster, IN 46321-2915

Phone 219-703-2401 · Fax 219-703-6687

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