Individual
DR. LOUIS MICELI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3125 WILLOWCREEK RD, PORTAGE, IN 46368-4423
(219) 762-3175
(219) 763-3092
Mailing address
2022 KELLE DR, CHESTERTON, IN 46304-8708
(219) 364-3616
(219) 364-3610
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02000622
IN
208000000X
Pediatrics Physician
02000622
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200272830A
—
IN
Enumeration date
06/20/2005
Last updated
09/28/2020
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