MEDICARE: HEART CENTER OF LAKE COUNTY,P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207UN0901X	Nuclear Cardiology Physician
2	207RC0000X	Cardiovascular Disease Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548224751
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEART CENTER OF LAKE COUNTY,P.C.

Provider Business Mailing Address
First Line	:	5800 BROADWAY
Second Line	:	SUITE A-J
City	:	MERRILLVILLE
State	:	IN
Zip	:	46410-2601
Country	:	US
Telephone Number	:	219-884-9180
Fax Number	:

Provider Business Practice Location Address
First Line	:	5800 BROADWAY
Second Line	:
City	:	MERRILLVILLE
State	:	IN
Zip	:	46410-2601
Country	:	US
Telephone Number	:	219-884-9180
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANDRE ARTIS
Credential	:	M.D.
Telephone Number	:	219-884-9180

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	01/07/2011

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Directions to “HEART CENTER OF LAKE COUNTY,P.C. ” Practice Location

Language	Start Address	Practice Location

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