Provider Demographics
NPI:1619306222
Name:CARDIOLOGY ASSOCIATES OF NW INDIANA, PC
Entity Type:Organization
Organization Name:CARDIOLOGY ASSOCIATES OF NW INDIANA, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING / COLLECTION MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOEFFLICKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-934-4210
Mailing Address - Street 1:10010 DON POWERS DR
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-4054
Mailing Address - Country:US
Mailing Address - Phone:219-934-4200
Mailing Address - Fax:219-934-6251
Practice Address - Street 1:10010 DON POWERS DR
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-4054
Practice Address - Country:US
Practice Address - Phone:219-934-4200
Practice Address - Fax:219-934-6251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01029887A207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN707050Medicare PIN