MEDICARE: ANDRE K ARTIS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	01037773	IN
2	207RC0000X	Cardiovascular Disease Physician	01037773	IN

General Provider Information

NPI Number	:	1811987688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDRE K ARTIS MD

Provider Business Mailing Address
First Line	:	5800 BROADWAY
Second Line	:	SUITE A-J
City	:	MERRILLVILLE
State	:	IN
Zip	:	46410-2601
Country	:	US
Telephone Number	:	219-884-9180
Fax Number	:	219-884-9280

Provider Business Practice Location Address
First Line	:	5800 BROADWAY
Second Line	:	SUITE A-J
City	:	MERRILLVILLE
State	:	IN
Zip	:	46410-2601
Country	:	US
Telephone Number	:	219-884-9180
Fax Number	:	219-884-9280

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2005
Last Update Date	:	10/05/2007

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