Gonzalez Rendon, Carlos Rafael

Gonzalez Rendon, Carlos Rafael is an individual health care provider with primary practice located at 10110 Don S Powers Dr Ste 202 , Munster IN 46321-4070. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Gonzalez Rendon, Carlos Rafael can be contacted via phone (219) 922-8222.

Contact Information

Primary practice address
10110 Don S Powers Dr Ste 202 Munster IN 46321-4070
Phone: (219) 922-8222
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 036.134436 Illinois
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X 11014829A Indiana
Allopathic & Osteopathic Physicians / Surgery 208600000X 01079893A Indiana

Profile Details

NPI number 1467688879
LBN Legal business name Gonzalez Rendon, Carlos Rafael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2009
Last updated Apr 30th, 2020 - about 6 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 1467688879 NPPES
Indiana MEDICAID 300034208

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