Healthcare Provider Details

I. General information

NPI: 1003148685
Provider Name (Legal Business Name): MEDICAL SPECIALISTS INC., PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2010
Last Update Date: 02/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9034 COLUMBIA AVE
MUNSTER IN
46321-2905
US

IV. Provider business mailing address

757-45TH STREET STE 201
MUNSTER IN
46321
US

V. Phone/Fax

Practice location:
  • Phone: 219-836-0296
  • Fax: 219-836-0570
Mailing address:
  • Phone: 219-934-2461
  • Fax: 219-934-2478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateIN

VIII. Authorized Official

Name: ALEXANDER A STEMER
Title or Position: PRESIDENT & CEO
Credential: MD
Phone: 219-934-2461