Boonjarern, Sampanta

Boonjarern, Sampanta is an individual health care provider with primary practice located at 297 Franciscan Dr , Crown Point IN 46307-4858. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Boonjarern, Sampanta can be contacted via phone (219) 622-1718.

Contact Information

Primary practice address
297 Franciscan Dr Crown Point IN 46307-4858
Phone: (219) 622-1718
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 01027321A Indiana

Profile Details

NPI number 1073514642
LBN Legal business name Boonjarern, Sampanta
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2005
Last updated Oct 5th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073514642 NPPES
Indiana Other 000000095595 ANTHEM BCBS NUMBER
Indiana MEDICAID 100168430A ANTHEM BCBS NUMBER
Indiana MEDICAID 100082060 ANTHEM BCBS NUMBER
Indiana Other 090001077 ANTHEM BCBS NUMBER

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