Organization · NPI-2

Cardiovascular Surgery Wtwk

Thoracic Surgery (Cardiothoracic Vascular Surgery) · Munster, IN

NPI number1912913526
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1912913526
Entity type
Organization (NPI-2)
Legal business name
Cardiovascular Surgery Wtwk
Organization subpart
No
Enumeration date
Aug 1, 2006
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery)––Yes

Practice location

801 Macarthur Blvd
Suite 205
Munster, IN 46321

Phone 219-836-4944 · Fax 219-836-5852

Mailing address

801 Macarthur Blvd
Suite 205
Munster, IN 46321

Phone 219-836-4944 · Fax 219-836-5852

Authorized official

Cris J Carlos
MD
2198364944

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