Individual
DR. THOMAS BACEVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7905 CALUMET AVE, HAMMOND CLINIC LLC, MUNSTER, IN 46321-1215
(219) 836-7214
(219) 836-5030
Mailing address
7905 CALUMET AVE, HAMMOND CLINIC LLC, MUNSTER, IN 46321-1215
(219) 836-7214
(219) 836-5030
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01035070A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100204410A
—
IN
Enumeration date
06/05/2006
Last updated
04/07/2015
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