Guanzon, Mateo

Guanzon, Mateo is an sole proprietor health care provider with primary practice located at 2150 Gettler St Ste 400 , Dyer IN 46311-2385. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Vascular Surgery, Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery). Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) is his primary health care specialty. Guanzon, Mateo can be contacted via phone (219) 865-0893.

Contact Information

Primary practice address
2150 Gettler St Ste 400 Dyer IN 46311-2385
Phone: (219) 865-0893
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 01035781A Indiana
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 01035781 Indiana
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 01035781A Indiana

Profile Details

NPI number 1629073366
LBN Legal business name Guanzon, Mateo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 17th, 2005
Last updated Mar 22nd, 2021 - about 5 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 1629073366 NPPES
Indiana MEDICAID 100346800
Indiana MEDICAID 300010982

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