Provider Demographics
NPI:1326198904
Name:NORTHWEST ORTHOPEDIC CONSULTANTS, INC.
Entity Type:Organization
Organization Name:NORTHWEST ORTHOPEDIC CONSULTANTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:LAMBERT
Authorized Official - Last Name:BONJEAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-769-4835
Mailing Address - Street 1:99 E 86TH AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-6381
Mailing Address - Country:US
Mailing Address - Phone:219-769-4835
Mailing Address - Fax:
Practice Address - Street 1:99 E 86TH AVE
Practice Address - Street 2:SUITE C
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6381
Practice Address - Country:US
Practice Address - Phone:219-769-4835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN50001234A207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
495210Medicare ID - Type Unspecified
0365520001Medicare NSC