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General NPI Number Information
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NPI Number | 1588750749
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Entity Type | Organization
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Legal Business Name | SURGICAL ASSOCIATES OF NORTHWEST INDIANA, P.C.
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 11/04/2009
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Provider Practice Location Address
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Address Line | 101 E 87TH AVE SUITE 420
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City | MERRILLVILLE
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State | IN
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Zip | 46410-7335
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Country | US
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Telephone | 219-756-4900
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Fax | 219-660-4108
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Provider Business Mailing Address
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Address Line | 101 E 87TH AVE SUITE 420
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City | MERRILLVILLE
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State | IN
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Zip | 46410-7335
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Country | US
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Telephone | 219-756-4900
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Fax | 219-660-4108
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. PAUL J STANISH
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Credential | M.D.
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Telephone | 219-756-4900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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