# ST MARGARET MERCY HEALTHCARE CENTERS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dyer Family Practice South
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457421836
- **Authorized official:** THOMAS GRYZBEK (PRESIDENT)
- **Authorized official phone:** (219) 932-2300

## Contact information

- **Practice address:** 14785 W 101ST AVE, DYER, IN 46311-3371
- **Practice address phone:** (219) 864-2235
- **Practice address fax:** (219) 864-1398
- **Mailing address:** PO BOX 1000, DYER, IN 46311-0800
- **Mailing address phone:** (219) 864-2107
- **Mailing address fax:** (219) 864-2649

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | — | NULL | — |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |

## Other

- **Enumeration date:** 11/09/2006
- **Last updated:** 06/23/2010