Organization
GREEN SURGICAL, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAREK SHAHBANDAR M.D. (OWNER)
(219) 750-9630
Entity
Organization
Contact information
Practice address
8687 CONNECTICUT ST, SUITE D, MERRILLVILLE, IN 46410-6361
(219) 750-9630
Mailing address
PO BOX 10713, MERRILLVILLE, IN 46411
(219) 750-9630
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
—
—
Other
Enumeration date
09/14/2016
Last updated
10/11/2016
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