Provider Demographics
NPI:1770751851
Name:MERRILLVILLE PLAZA ANESTHESIA CORPORATION
Entity type:Organization
Organization Name:MERRILLVILLE PLAZA ANESTHESIA CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAYAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-791-0500
Mailing Address - Street 1:255 E 90TH DR
Mailing Address - Street 2:SUITE W-2
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-8144
Mailing Address - Country:US
Mailing Address - Phone:219-791-0500
Mailing Address - Fax:219-791-0566
Practice Address - Street 1:255 E 90TH DR
Practice Address - Street 2:SUITE W-2
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-8144
Practice Address - Country:US
Practice Address - Phone:219-791-0500
Practice Address - Fax:219-791-0566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center