Provider Demographics
NPI:1265726673
Name:DIGESTIVE HEALTHCARE SPECIALISTS LLC
Entity type:Organization
Organization Name:DIGESTIVE HEALTHCARE SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:E
Authorized Official - Last Name:FUMO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-872-6566
Mailing Address - Street 1:8865 W 400 N STE 155
Mailing Address - Street 2:
Mailing Address - City:MICHIGAN CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46360-9010
Mailing Address - Country:US
Mailing Address - Phone:219-872-6566
Mailing Address - Fax:219-872-2712
Practice Address - Street 1:8865 W 400 N STE 155
Practice Address - Street 2:
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-9010
Practice Address - Country:US
Practice Address - Phone:219-872-6566
Practice Address - Fax:219-872-2712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty