Healthcare Provider Details

I. General information

NPI: 1912213737
Provider Name (Legal Business Name): TAMER CALEEL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2010
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9011 E 109TH AVE
CROWN POINT IN
46307-7652
US

IV. Provider business mailing address

9011 E 109TH AVE
CROWN POINT IN
46307-7652
US

V. Phone/Fax

Practice location:
  • Phone: 219-299-5341
  • Fax: 219-244-5422
Mailing address:
  • Phone: 219-299-5341
  • Fax: 219-244-5422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number02004714A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: