Wangstrom, Neil William
Wangstrom, Neil William is an individual health care provider with primary practice located at 304 Detroit St , La Porte IN 46350-2497. He recently has 6 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Otolaryngology, Allopathic & Osteopathic Physicians / Pediatric Otolaryngology, Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck, Allopathic & Osteopathic Physicians / Otolaryngic Allergy, Allopathic & Osteopathic Physicians / Otology & Neurotology, Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery. Allopathic & Osteopathic Physicians / Otolaryngology is his primary health care specialty. Wangstrom, Neil William can be contacted via phone (219) 325-3770.Contact Information
Primary practice address
304 Detroit St
La Porte IN 46350-2497
Phone: (219) 325-3770
Fax: (219) 325-8181
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | 01038858 | Indiana |
| Allopathic & Osteopathic Physicians / Pediatric Otolaryngology | 207YP0228X | 01038858 | Indiana |
| Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck | 207YX0007X | 01038858 | Indiana |
| Allopathic & Osteopathic Physicians / Otolaryngic Allergy | 207YX0602X | 01038858 | Indiana |
| Allopathic & Osteopathic Physicians / Otology & Neurotology | 207YX0901X | 01038858 | Indiana |
| Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery | 207YX0905X | 01038858 | Indiana |
Profile Details
| NPI number | 1730189820 |
|---|---|
| LBN Legal business name | Wangstrom, Neil William |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 29th, 2005 |
| Last updated | Sep 16th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730189820 | NPPES |
| Indiana | Other | M400041676 | MEDICARE PTAN |
| Indiana | Other | 000000697664 | MEDICARE PTAN |
| Indiana | MEDICAID | 100165330 | MEDICARE PTAN |
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