Organization
THE INSTITUTE OF FOOT & ANKLE RECONSTRUCTIVE SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AHMAD KASSEM ELSAMAD DPM (PODIATRIST)
(219) 488-6409
Entity
Organization
Contact information
Practice address
9239 BROADWAY, MERRILLVILLE, IN 46410-7046
(219) 736-1010
(219) 736-1090
Mailing address
9120 DOUBLETREE DR S, CROWN POINT, IN 46307-7655
(219) 779-9407
(219) 779-9403
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
07001024A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200824830A
—
IN
Enumeration date
09/18/2007
Last updated
07/24/2013
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