Organization
ALBERT WILLARDO MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALBERT WILLARDO MD (OWNER/PHYSICIAN)
(219) 845-2030
Entity
Organization
Contact information
Practice address
7150 INDIANAPOLIS BLVD, HAMMOND, IN 46324-2245
(219) 845-2030
(219) 989-0257
Mailing address
55 E 86TH AVE, PO BOX 10645, MERRILLVILLE, IN 46410-6382
(219) 769-1670
(219) 738-6714
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
01020554
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100161690A
—
IN
Enumeration date
02/08/2008
Last updated
02/08/2008
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