Organization
ST MARGARET MERCY HEALTHCARE CENTERS
Active
Other names
Douglas Park Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS GRYZBEK (PRESIDENT)
(219) 932-2300
Entity
Organization
Contact information
Practice address
3831 S HOHMAN AVE, HAMMOND, IN 46327-1160
(219) 931-1960
(219) 931-1235
Mailing address
PO BOX 1000, DYER, IN 46311-0800
(219) 864-2107
(219) 864-2251
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200159110F
—
IN
Enumeration date
11/03/2006
Last updated
06/23/2010
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