Organization
STREAM CLINICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHETAN PURANIK MD (MEMBER)
(219) 476-7246
Entity
Organization
Contact information
Practice address
1928 45TH ST, MUNSTER, IN 46321-3917
(219) 476-7246
(219) 242-8972
Mailing address
204 LEGACY PLZ W, LA PORTE, IN 46350-5285
(219) 476-7246
(219) 242-8972
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Enumeration date
10/31/2018
Last updated
10/31/2018
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