Individual
CHETAN PURANIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
504 LEGACY PLZ W, LA PORTE, IN 46350-5254
(219) 326-7246
(219) 326-7234
Mailing address
204 LEGACY PLZ W, LA PORTE, IN 46350-5285
(219) 326-7246
(219) 476-1713
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01063580A
IN
207L00000X
Anesthesiology Physician
036112296
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
01063580A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200857580
—
IN
Enumeration date
01/11/2007
Last updated
03/27/2018
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