Organization
MULTICARE PHYSICIAN CENTER PC
Active
Other names
D Katsoros MD
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM MLYNARCIK (VICE PRESIDENT)
(219) 712-6130
Entity
Organization
Contact information
Practice address
7863 BROADWAY, STE 135, MERRILLVILLE, IN 46410
(219) 736-2047
(219) 736-2048
Mailing address
7863 BROADWAY, STE 135, MERRILLVILLE, IN 46410
(219) 548-0837
(219) 548-0857
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01049411
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000080178
BLUE CROSS BLUE SHIELD
IN
05
—
200195840B
—
IN
Enumeration date
02/28/2007
Last updated
05/29/2019
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