Organization
MARK NOOTENS, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NATALIE NOOTENS (OFFICE MANAGER)
(219) 513-0107
Entity
Organization
Contact information
Practice address
931 FRAN LIN PKWY, MUNSTER, IN 46321-3540
(219) 513-0107
(219) 513-0108
Mailing address
931 FRAN LIN PKWY, MUNSTER, IN 46321-3540
(219) 513-0107
(219) 513-0108
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01042703
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000243924
BCBS
IN
01
—
1568491975
PHYCISIAN NPI
—
05
—
200043060B
—
IN
01
—
330467487
IL MEDICAID
IL
Enumeration date
01/26/2010
Last updated
03/16/2021
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