# TERRY EBERT, MD, INC

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

## Provider details

- **NPI number:** 1417173717
- **Authorized official:** DR. TERRY W EBERT M.D. (PRESIDENT)
- **Authorized official phone:** (219) 836-1050

## Contact information

- **Practice address:** 509 RIDGE RD, SUITE 1, MUNSTER, IN 46321-1643
- **Practice address phone:** (219) 836-1050
- **Practice address fax:** (219) 836-4969
- **Mailing address:** 509 RIDGE RD, SUITE 1, MUNSTER, IN 46321-1643
- **Mailing address phone:** (219) 836-1050
- **Mailing address fax:** (219) 836-4969

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 01022150A | IN | Yes |

## Other

- **Enumeration date:** 04/17/2007
- **Last updated:** 03/07/2023