Provider Demographics
NPI:1528030889
Name:VINLUAN, TEOFILO S (MD)
Entity Type:Individual
Prefix:DR
First Name:TEOFILO
Middle Name:S
Last Name:VINLUAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375-0190
Mailing Address - Country:US
Mailing Address - Phone:219-769-6545
Mailing Address - Fax:219-227-8920
Practice Address - Street 1:1217 US HIGHWAY 41
Practice Address - Street 2:
Practice Address - City:SCHERERVILLE
Practice Address - State:IN
Practice Address - Zip Code:46375-1311
Practice Address - Country:US
Practice Address - Phone:219-769-6545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01057042A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
INC24784Medicare UPIN
INP00887763Medicare PIN
IN203850BMedicare ID - Type Unspecified
IN249340CMedicare PIN
IN200367240Medicare ID - Type Unspecified