Petrungaro, Jason Michael

Petrungaro, Jason Michael is an sole proprietor health care provider with primary practice located at 800 Macarthur Blvd Suite 21, Munster IN 46321-2917. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as his primary health care specialty. Petrungaro, Jason Michael can be contacted via phone (219) 836-1163.

Contact Information

Primary practice address
800 Macarthur Blvd Suite 21 Munster IN 46321-2917
Phone: (219) 836-1163
Fax: (844) 270-6677
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X N9993 Texas
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X 01074460A Indiana

Profile Details

NPI number 1871765057
LBN Legal business name Petrungaro, Jason Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 28th, 2008
Last updated Aug 3rd, 2016 - about 9 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 1871765057 NPPES
Texas Other 8DT481 BLUE CROSS BLUE SHIELD
Texas Other MEDICARE BLUE CROSS BLUE SHIELD
Texas Other P01602561 BLUE CROSS BLUE SHIELD
Texas Other 0914915 BLUE CROSS BLUE SHIELD

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