Dershewitz, Robert A

Dershewitz, Robert A is an individual health care provider with primary practice located at 9660 Wicker Avenue 2Nd Floor, St John IN 46373-9487. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Dershewitz, Robert A can be contacted via phone (219) 226-2380.

Contact Information

Primary practice address
9660 Wicker Avenue 2Nd Floor St John IN 46373-9487
Phone: (219) 226-2380
Fax: (219) 226-2381
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 01051751 Indiana

Profile Details

NPI number 1649271412
LBN Legal business name Dershewitz, Robert A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2005
Last updated Jun 17th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649271412 NPPES
Indiana MEDICAID 200254250A
Indiana Other 000000081284

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