Organization
HERITAGE EAR , NOSE & THROAT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HAROON NAZ (CEO)
(219) 756-2100
Entity
Organization
Contact information
Practice address
1651 THORNAPPLE CIR, VALPARAISO, IN 46385-5496
(219) 462-9937
Mailing address
PO BOX 261, VALPARAISO, IN 46384-0261
(219) 476-0352
(219) 531-0859
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000091423
ANTHEM BC/BS
IN
05
—
100209930A
—
IN
Enumeration date
06/18/2007
Last updated
01/18/2012
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