Organization
PREMISE HEALTH OF INDIANA MEDICAL, P.C.
Active
Other names
Steel Family Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
JON LEIZMAN M.D. (PRESIDENT)
(216) 479-9063
Entity
Organization
Contact information
Practice address
2022 KELLE DR, CHESTERTON, IN 46304-8708
(219) 395-2200
(219) 983-1837
Mailing address
5500 MARYLAND WAY STE 120, BRENTWOOD, TN 37027-4993
(216) 479-9063
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
170220
MEDICARE PTAN
IN
01
—
CB6836
GROUP RAILROAD NUMBER
IN
Enumeration date
12/19/2006
Last updated
08/25/2022
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