Individual
CRISOSTOMO J CARLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 MACARTHUR BLVD, SUITE 305, MUNSTER, IN 46321-2915
(219) 703-2401
(219) 703-6687
Mailing address
801 MACARTHUR BLVD, SUITE 305, MUNSTER, IN 46321-2915
(219) 703-2401
(219) 703-6687
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
01026571A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100349730
—
IN
Enumeration date
07/13/2006
Last updated
01/10/2017
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