Organization
ORTHOPAEDIC SPECIALISTS OF NORTHWEST INDIANA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA HACKETT (BILLING LEAD)
(219) 934-2652
Entity
Organization
Contact information
Practice address
9900 COLUMBIA AVE, MUNSTER, IN 46321-4008
(219) 924-3300
Mailing address
PO BOX 3329, MUNSTER, IN 46321-0329
(219) 924-3300
(219) 934-2658
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000104771
ANTHEM GROUP
IN
01
—
129555400
US DEPT LABOR
—
05
—
200135850A
—
IN
01
—
90000692
BCIL
—
Enumeration date
08/30/2006
Last updated
02/12/2025
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