Organization
DAVID S. MENDELOWITZ MD SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID SAMUEL MENDELOWITZ MD (PRESIDENT)
(219) 325-0152
Entity
Organization
Contact information
Practice address
1300 STATE ST STE 2C, LA PORTE, IN 46350-3134
(219) 325-0152
(219) 325-8621
Mailing address
1300 STATE ST STE 2C, LA PORTE, IN 46350-3134
(219) 325-0152
(219) 325-8621
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01030941A
IN
246ZC0007X
Surgical Assistant
2989
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000093837
ANTHEM
IN
Enumeration date
12/09/2008
Last updated
12/09/2008
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