Organization
NORTHWEST INDIANA NEPHROLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AJ PAMPALONE DO (PRESIDENT)
(219) 836-2022
Entity
Organization
Contact information
Practice address
2711 LEONARD DR STE 101, VALPARAISO, IN 46383-7121
(219) 462-6001
(219) 462-6060
Mailing address
2711 LEONARD DR STE 101, VALPARAISO, IN 46383-7121
(219) 462-6001
(219) 462-6060
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201062390
—
IN
Enumeration date
04/19/2012
Last updated
03/31/2020
Update your record
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