Organization
NORTHWEST INDIANA SPINAL SURGERY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIAN M SHEPHERD MD (PRESIDENT)
(219) 738-2255
Entity
Organization
Contact information
Practice address
9235 BROADWAY, MERRILLVILLE, IN 46410-7046
(219) 738-2255
(219) 738-2060
Mailing address
9235 BROADWAY, MERRILLVILLE, IN 46410-7046
(219) 738-2255
(219) 738-2060
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
01033705A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100195070A
—
IN
Enumeration date
09/07/2006
Last updated
06/19/2008
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