Healthcare Provider Details

I. General information

NPI: 1235193566
Provider Name (Legal Business Name): NORTHERN IN HEART RHYTHM SPECIALISTS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 09/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S LAKE PARK AVE ELECTROPHYSIOLOGY LAB
HOBART IN
46342-6638
US

IV. Provider business mailing address

9201 CALUMET AVE
MUNSTER IN
46321-2807
US

V. Phone/Fax

Practice location:
  • Phone: 219-947-6767
  • Fax:
Mailing address:
  • Phone: 219-836-9024
  • Fax: 219-836-0034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State

VIII. Authorized Official

Name: SCOTT KAUFMAN
Title or Position: PRESIDENT
Credential: D.O.
Phone: 219-836-9024