Individual
DR. JUSTIN P COLANESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12800 MISSISSIPPI PKWY STE A201, CROWN POINT, IN 46307-6902
(219) 921-1444
(219) 921-5303
Mailing address
601 GATEWAY BLVD N, CHESTERTON, IN 46304-9658
(219) 921-1444
(219) 921-5303
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01082195A
IN
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
036143827
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300029845
—
IN
Enumeration date
04/06/2011
Last updated
07/21/2022
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