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Organization

ST. MARY MEDICAL CENTER INC

Active
Parent organization
ST. MARY MEDICAL CENTER INC
Other names
Michael Kovacich MD
Organization subpart
Yes

Provider details

NPI number
Legal business name
ST. MARY MEDICAL CENTER INC
Authorized official
JANICE RYBA (CEO)
(219) 942-0551
Entity
Organization

Contact information

Practice address
200 E 80TH PLACE, STE 100, MERRILLVILLE, IN 46410-5671
(219) 769-7536
(219) 736-1506
Mailing address
9660 WICKER AVENUE, ST JOHN, IN 46373-9487
(219) 226-2203
(219) 226-2202

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200251650
IN
Enumeration date
11/20/2006
Last updated
07/11/2024
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