Individual
DR. MICHAEL STUART HAWTHORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1007 LINCOLNWAY, LA PORTE, IN 46350
(219) 326-1234
(219) 326-2699
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01074353A
IN
207P00000X
Emergency Medicine Physician
04-31890
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200389880A
—
KS
Enumeration date
08/17/2006
Last updated
08/21/2019
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