Provider Demographics
NPI:1417018094
Name:P.R. UNNI PC
Entity Type:Organization
Organization Name:P.R. UNNI PC
Other - Org Name:UROLOGY CONSULTANTS OF NW INDIANA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:P
Authorized Official - Middle Name:R
Authorized Official - Last Name:UNNI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-769-8641
Mailing Address - Street 1:371 E 84TH DR
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-6484
Mailing Address - Country:US
Mailing Address - Phone:219-769-8641
Mailing Address - Fax:219-769-2280
Practice Address - Street 1:371 E 84TH DR
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6484
Practice Address - Country:US
Practice Address - Phone:219-769-8641
Practice Address - Fax:219-769-2280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1407989932OtherNPI INDIVIDUAL
IN1427039205OtherNPI INDIVIDUAL
IN1063493542OtherNPI INDIVIDUAL
IN1407989932OtherNPI INDIVIDUAL
IN1427039205OtherNPI INDIVIDUAL
INE05524Medicare UPIN
IN1063493542OtherNPI INDIVIDUAL