Individual
DR. NICHOLAS EDWARD MAZUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5454 HOHMAN AVE, HAMMOND, IN 46320-1931
(219) 933-2077
Mailing address
3531 REDWING CT, NAPERVILLE, IL 60564-8304
(773) 405-1509
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
02004584A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/16/2011
Last updated
06/25/2015
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