Organization
JOSEPH A DEJOAN MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH A DEJOAN M.D. (PRESIDENT)
(219) 462-0508
Entity
Organization
Contact information
Practice address
3301 CALUMET AVE, VALPARAISO, IN 46383-2614
(219) 462-0508
(219) 531-9032
Mailing address
PO BOX 261, VALPARAISO, IN 46384-0261
(219) 476-0352
(219) 531-0859
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01046269A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000526797
ANTHEM BC/BS
IN
05
—
200887940
—
IN
Enumeration date
07/06/2007
Last updated
05/14/2008
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