Organization
ST. MARGARET MERCY HEALTHCARE CENTERS, INC
Active
Other names
Ear Nose and Throat Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS GRYZBEK (PRESIDENT)
(219) 933-2300
Entity
Organization
Contact information
Practice address
5500 HOHMAN AVENUE, SUITE 2A, HAMMOND, IN 46320-1942
(219) 852-1505
(219) 852-1510
Mailing address
PO BOX 1000, DYER, IN 46311-0800
(219) 864-2107
(219) 864-2649
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200504980
—
IN
Enumeration date
07/22/2008
Last updated
09/25/2008
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