Miceli, Louis

Miceli, Louis is an individual health care provider with primary practice located at 3125 Willowcreek Rd , Portage IN 46368-4423. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Miceli, Louis can be contacted via phone (219) 762-3175.

Contact Information

Primary practice address
3125 Willowcreek Rd Portage IN 46368-4423
Phone: (219) 762-3175
Fax: (219) 763-3092
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 02000622 Indiana
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 02000622 Indiana

Profile Details

NPI number 1679578272
LBN Legal business name Miceli, Louis
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2005
Last updated Sep 28th, 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 1679578272 NPPES
Indiana MEDICAID 200272830A

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