Organization
GAMA PC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY YESSENOW MD (PRESIDENT)
(219) 513-1300
Entity
Organization
Contact information
Practice address
9250 COLUMBIA AVE, STE 2A, MUNSTER, IN 46321
(219) 513-1300
(219) 513-2385
Mailing address
9250 COLUMBIA AVE, STE 2A, MUNSTER, IN 46321
(219) 513-1300
(219) 513-2385
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
01030811A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000048616
ANTHEM
IN
Enumeration date
01/10/2008
Last updated
04/29/2008
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