Provider Demographics
NPI:1639794597
Name:REGION VEIN
Entity Type:Organization
Organization Name:REGION VEIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEMETRIOS
Authorized Official - Middle Name:
Authorized Official - Last Name:KARAMICHOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-595-3095
Mailing Address - Street 1:931 RIDGE RD STE C
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-1756
Mailing Address - Country:US
Mailing Address - Phone:219-595-3095
Mailing Address - Fax:219-881-8776
Practice Address - Street 1:931 RIDGE RD STE C
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-1756
Practice Address - Country:US
Practice Address - Phone:219-595-3095
Practice Address - Fax:219-881-8776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-16
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebologyGroup - Single Specialty