Organization
CARDIOVASCULAR THORACIC ASSOCIATES OF LAKE COUNTY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID JAYAKAR M.D. (PRESIDENT)
(219) 836-2022
Entity
Organization
Contact information
Practice address
4320 FIR ST, SUITE 210, EAST CHICAGO, IN 46312-3052
(219) 228-4776
Mailing address
9201 CALUMET AVE, MUNSTER, IN 46321-2807
(219) 836-2022
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200805090
—
IN
Enumeration date
04/14/2006
Last updated
03/18/2008
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