Organization
NORTHERN INDIANA ORTHOPAEDICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GENE VICTOR FEDOR M.D. (PRESIDENT)
(219) 947-5606
Entity
Organization
Contact information
Practice address
1400 S LAKE PARK AVE STE 200, HOBART, IN 46342-6636
(219) 947-5606
(219) 942-4742
Mailing address
PO BOX 306, DEMOTTE, IN 46310-0306
(219) 947-5606
(219) 942-4742
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01043359A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000184715
BLUE CROSS BLUE SHIELD
IN
Enumeration date
02/28/2007
Last updated
11/30/2007
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