Individual
DOUGLAS ADOLPH MAZUREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1101 GLENDALE BLVD, SUITE 103, VALPARAISO, IN 46383-3767
(219) 464-9054
(219) 465-1749
Mailing address
2022 KELLE DR, CHESTERTON, IN 46304-8708
(219) 364-3616
(219) 364-3610
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01038566A
IN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
01038566
IN
207RP1001X
Pulmonary Disease Physician
01038566
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200016720
—
IN
Enumeration date
08/18/2006
Last updated
09/11/2020
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