Dershewitz, Robert A
Dershewitz, Robert A is an individual health care provider with primary practice located at 9660 Wicker Avenue 2Nd Floor, St John IN 46373-9487. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Dershewitz, Robert A can be contacted via phone (219) 226-2380.Contact Information
Primary practice address
9660 Wicker Avenue 2Nd Floor
St John IN 46373-9487
Phone: (219) 226-2380
Fax: (219) 226-2381
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 01051751 | Indiana |
Profile Details
| NPI number | 1649271412 |
|---|---|
| LBN Legal business name | Dershewitz, Robert A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 3rd, 2005 |
| Last updated | Jun 17th, 2010 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649271412 | NPPES |
| Indiana | MEDICAID | 200254250A | |
| Indiana | Other | 000000081284 |
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