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:
Map and Directions
Authorized official contact:
Name: Bressack, Mitchell Leslie Doctor of Medicine (MD)
Phone: (219) 662-8856

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134585029 NPPES
Indiana MEDICAID 201294150
Indiana MEDICAID 100214910A
Indiana MEDICAID 200039710A

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