Individual
DR. KEITH ATASSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3800 SAINT MARY RD STE 202, VALPARAISO, IN 46383-3986
(219) 286-3788
(219) 286-3791
Mailing address
3800 SAINT MARY RD STE 202, VALPARAISO, IN 46383-3986
(219) 286-3788
(219) 286-3791
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
01038771A
IN
207RI0011X
Interventional Cardiology Physician
Primary
01038771A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000183526
BLUE CROSS BLUE SHIELD IN
—
01
—
060034739
RAILROAD MEDICARE
—
05
—
100356630
—
IN
01
—
90000561
BLUE SHIELD OF IL
—
Enumeration date
07/21/2006
Last updated
09/30/2020
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