Organization
MUNSTER RADIOLOGY GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN GUSTAITIS M.D. (PRESIDENT)
(219) 836-2022
Entity
Organization
Contact information
Practice address
901 MACARTHUR BLVD, RADIOLOGY DEPARTMENT, MUNSTER, IN 46321-2901
(219) 836-4569
Mailing address
PO BOX 10907, MERRILLVILLE, IN 46411-0907
(800) 379-8731
(614) 771-2248
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
—
IN
2085N0700X
Neuroradiology Physician
—
IN
2085N0904X
Nuclear Radiology Physician
—
IN
2085R0202X
Diagnostic Radiology Physician
Primary
—
IN
2085R0204X
Vascular & Interventional Radiology Physician
—
IN
2085R0205X
Radiological Physics Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100158170
—
IN
Enumeration date
12/29/2005
Last updated
12/12/2012
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