Organization
VEIN CENTERS OF NORTHWEST IN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATEO V. GUANZON M.D. (PRESIDENT)
(219) 836-2022
Entity
Organization
Contact information
Practice address
9305 CALUMET AVE, SUITE E-2, MUNSTER, IN 46321-2887
(219) 836-1555
Mailing address
9201 CALUMET AVE, MUNSTER, IN 46321-2807
(219) 836-2022
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
01035781A
IN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
01035781A
IN
Other
Enumeration date
07/08/2006
Last updated
03/22/2011
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