Healthcare Provider Details

I. General information

NPI: 1609874254
Provider Name (Legal Business Name): NOVAMED SURGERY CENTER OF MERRILLVILLE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9797 MASSACHUSETTS ST
CROWN POINT IN
46307-0278
US

IV. Provider business mailing address

9797 MASSACHUSETTS ST
CROWN POINT IN
46307-0278
US

V. Phone/Fax

Practice location:
  • Phone: 219-756-5010
  • Fax: 219-756-5106
Mailing address:
  • Phone: 219-756-5010
  • Fax: 219-756-5106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number05-005727-1
License Number StateIN

VIII. Authorized Official

Name: MS. SUE GLASS
Title or Position: BILLING MANAGER
Credential:
Phone: 219-937-5067