Organization
CD EGNATZ MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES DYKE EGNATZ MD (OWNER PRESIDENT)
(219) 865-2691
Entity
Organization
Contact information
Practice address
1326 W US ROUTE 30, SCHERERVILLE, IN 46375
(219) 865-2691
(219) 322-5928
Mailing address
1326 W US ROUTE 30, SCHERERVILLE, IN 46375
(219) 865-2691
(219) 322-5928
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01019054A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000086644
BCBS
IN
Enumeration date
10/10/2006
Last updated
08/22/2020
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