Mazurek, Douglas Adolph

Mazurek, Douglas Adolph is an individual health care provider with primary practice located at 1101 Glendale Blvd Suite 103, Valparaiso IN 46383-3767. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease, Other Service Providers / Specialist. Other Service Providers / Specialist is his primary health care specialty. Mazurek, Douglas Adolph can be contacted via phone (219) 464-9054.

Contact Information

Primary practice address
1101 Glendale Blvd Suite 103 Valparaiso IN 46383-3767
Phone: (219) 464-9054
Fax: (219) 465-1749
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 01038566 Indiana
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 01038566 Indiana
Other Service Providers / Specialist 174400000X 01038566A Indiana

Profile Details

NPI number 1033223235
LBN Legal business name Mazurek, Douglas Adolph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2006
Last updated Sep 11th, 2020 - about 5 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 1033223235 NPPES
Indiana MEDICAID 200016720

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