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Individual

DR. LARRY J. WAPIENNIK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
11406 BROADWAY, CROWN POINT, IN 46307-7106
(219) 663-7737
(219) 663-7733
Mailing address
11406 BROADWAY, CROWN POINT, IN 46307-7106
(219) 663-7737
(219) 663-7733

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
07000451A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000086346
ANTHEM
IN
01
000000086347
ANTHEM
IN
01
480014055
RAILROAD MEDICARE
IN
01
8615234002
CIGNA
IN
01
90001028
BLUE CROSS BLUE SHIELD IL
IN
Enumeration date
01/14/2007
Last updated
06/04/2010
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