Diveris, John M

Diveris, John M is an sole proprietor health care provider with primary practice located at 333 W 89Th Ave Suite W5, Merrillville IN 46410-7073. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Diveris, John M can be contacted via phone (219) 755-4448.

Contact Information

Primary practice address
333 W 89Th Ave Suite W5 Merrillville IN 46410-7073
Phone: (219) 755-4448
Fax: (219) 755-4454
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 01040065A Indiana

Profile Details

NPI number 1831198324
LBN Legal business name Diveris, John M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 18th, 2005
Last updated Aug 27th, 2012 - about 13 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 1831198324 NPPES
Indiana Other 000000381584 ANTHEM
Indiana MEDICAID 200010670 ANTHEM

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