# VEIN CENTERS OF NORTHWEST IN

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124051735
- **Authorized official:** MATEO V. GUANZON M.D. (PRESIDENT)
- **Authorized official phone:** (219) 836-2022

## Contact information

- **Practice address:** 9305 CALUMET AVE, SUITE E-2, MUNSTER, IN 46321-2887
- **Practice address phone:** (219) 836-1555
- **Mailing address:** 9201 CALUMET AVE, MUNSTER, IN 46321-2807
- **Mailing address phone:** (219) 836-2022

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | 01035781A | IN | — |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 01035781A | IN | Yes |

## Other

- **Enumeration date:** 07/08/2006
- **Last updated:** 03/22/2011