Provider Demographics
NPI:1679635197
Name:JUHASZ, ANNABELLA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNABELLA
Middle Name:
Last Name:JUHASZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 COMMERCE SQUARE
Mailing Address - Street 2:
Mailing Address - City:MICHIGAN CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46360-3282
Mailing Address - Country:US
Mailing Address - Phone:219-879-2663
Mailing Address - Fax:219-879-3649
Practice Address - Street 1:230 COMMERCE SQUARE
Practice Address - Street 2:
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-3282
Practice Address - Country:US
Practice Address - Phone:219-879-2663
Practice Address - Fax:219-879-3649
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01036267207X00000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100164850AMedicaid
IN487630Medicare ID - Type Unspecified
D14748Medicare UPIN