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General NPI Number Information
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NPI Number | 1760923957
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Entity Type | Individual
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Provider Name | PATRICK DAVID ALBERT MD
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Gender | Male
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Dates
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Enumeration Date | 03/20/2017
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Last Update Date | 08/12/2024
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Provider Practice Location Address
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Address Line | 8865 W 400 N STE 175
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City | MICHIGAN CITY
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State | IN
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Zip | 46360-9010
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Country | US
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Telephone | 219-877-2225
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Fax | 219-877-2230
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Provider Business Mailing Address
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Address Line | PO BOX 781076
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City | DETROIT
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State | MI
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Zip | 48278-1076
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Country | US
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Telephone | 317-528-4800
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Fax | 317-865-1479
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 01091243A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 01091243A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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