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Individual

VIMAL B PATHAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1000 E 80TH PLACE, SUITE 308 SOUTH TOWER, MERRILLVILLE, IN 46410
(219) 736-8118
(219) 736-7583
Mailing address
1000 E 80TH PLACE, SUITE 308 SOUTH TOWER, MERRILLVILLE, IN 46410
(219) 736-8118
(219) 736-7583

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01034936A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000328376
ANTHEM BC/BS
IN
Enumeration date
03/24/2006
Last updated
11/23/2011
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