Organization
VEIN ASSOCIATES OF NORTHWEST INDIANA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMJAD ALKADRI MD (CEO/MEDICAL DIRECTOR)
(219) 736-8118
Entity
Organization
Contact information
Practice address
1000 E 80TH PL, SUITE 308S, MERRILLVILLE, IN 46410-5608
(219) 736-8118
Mailing address
1000 E 80TH PL, SUITE 308S, MERRILLVILLE, IN 46410-5608
(219) 736-8118
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
01052522A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201206110A
—
IN
05
—
201206110B
—
IN
Enumeration date
12/18/2013
Last updated
04/04/2014
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