Organization
ST. MARGARET MERCY HEALTHCARE CENTERS, INC
Active
Other names
Munster Orthopedic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS GRYZBEK (PRESIDENT)
(219) 933-2300
Entity
Organization
Contact information
Practice address
8242 CALUMET AVENUE, MUNSTER, IN 46321-1704
(219) 836-6166
Mailing address
PO BOX 1000, DYER, IN 46311-0800
(219) 864-2107
(219) 864-2649
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01026776A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200504980
—
IN
Enumeration date
01/10/2007
Last updated
11/05/2008
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