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Individual

DR. LARRY JOHN WAPIENNIK II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
11406 BROADWAY, CROWN POINT, IN 46307-7106
(219) 663-7737
(219) 663-7733
Mailing address
11406 BROADWAY, CROWN POINT, IN 46307-7106
(219) 663-7737
(219) 663-7733

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
07000898A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000080047
ANTHEM BC BS PIN NUMBER
IN
01
000000080048
ANTHEM BC BS PIN NUMBER
IN
01
3789456002
CIGNA
IN
01
5399611
AETNA GROUP ID
IN
01
7890048
AETNA PERSONAL ID
IN
01
90001030
BC BS OF ILLINOIS
IN
Enumeration date
01/22/2007
Last updated
07/14/2010
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