Dermatology Center Of Northwest Indiana, Pc
LBN: Dermatology Center Of Northwest Indiana, Pc
Dermatology Center Of Northwest Indiana, Pc is an health care organization with primary practice located at 70 W 94Th Pl , Crown Point IN 46307-1710. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Dermatopathology, Physician Assistants & Advanced Practice Nursing Providers / Medical. Allopathic & Osteopathic Physicians / Dermatology is the primary health care specialty.
Dermatology Center Of Northwest Indiana, Pc can be contacted via phone (219) 662-8822, or through Bressack, Mitchell Leslie via phone (219) 662-8856.
Contact Information
Primary practice address
70 W 94Th Pl
Crown Point IN 46307-1710
Phone: (219) 662-8822
Fax: (219) 662-8833
Website:
Authorized official contact:
Name: Bressack, Mitchell Leslie Doctor of Medicine (MD)
Phone: (219) 662-8856
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 01031629A | Indiana |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 02004576A | Indiana |
| Allopathic & Osteopathic Physicians / Dermatopathology | 207ND0900X | 01043884A | Indiana |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 10000889A | Indiana |
Profile Details
| NPI number | 1134585029 |
|---|---|
| LBN Legal business name | Dermatology Center Of Northwest Indiana, Pc |
| DBA Doing business as | |
| Authorized official | Bressack, Mitchell Leslie Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 7th, 2016 |
| Last updated | Jan 7th, 2016 - about 9 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134585029 | NPPES |
| Indiana | MEDICAID | 201294150 | |
| Indiana | MEDICAID | 100214910A | |
| Indiana | MEDICAID | 200039710A |
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