Provider Demographics
NPI:1083625875
Name:VELANDER, KARIN F (MD)
Entity Type:Individual
Prefix:
First Name:KARIN
Middle Name:F
Last Name:VELANDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KARIN
Other - Middle Name:P
Other - Last Name:FORSHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:68 HILLCREST RD
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:IN
Mailing Address - Zip Code:46368-1075
Mailing Address - Country:US
Mailing Address - Phone:219-548-0360
Mailing Address - Fax:219-548-0358
Practice Address - Street 1:505 SILHAVY RD STE 800
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-4410
Practice Address - Country:US
Practice Address - Phone:219-548-0360
Practice Address - Fax:219-548-0358
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01028807A174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IND13882Medicare UPIN
IN192710Medicare ID - Type Unspecified