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Organization
LAKE-PORTER CARDIOVASCULAR PC
Active
Organization
LAKE-PORTER CARDIOVASCULAR PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCIA POWERS (OFFICE MANAGER)
(219) 477-4452
Entity
Organization
Contact information
Practice address
2000 ROOSEVELT RD STE 101, VALPARAISO, IN 46383-2801
(219) 462-1619
(219) 548-0867
Mailing address
2000 ROOSEVELT RD STE 101, VALPARAISO, IN 46383-2801
(219) 462-1619
(219) 548-0867
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
50000940A
IN
Other
Enumeration date
09/27/2006
Last updated
12/12/2019
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