Individual
MATINA J GEORGEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
901 MACARTHUR BLVD, ANESTHESIA DEPT, MUNSTER, IN 46321-2901
(219) 836-7040
(219) 513-1127
Mailing address
901 MACARTHUR BLVD, ANESTHESIA DEPT, MUNSTER, IN 46321-2901
(219) 836-7040
(219) 513-1127
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28125475A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036108031
—
IL
05
—
200859270
—
IN
Enumeration date
05/02/2007
Last updated
09/25/2015
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