Northwest Indiana Ent Assoicates

LBN: Neil Wangstrom Md Pc
Northwest Indiana Ent Assoicates is an health care organization with primary practice located at 304 Detroit St , La Porte IN 46350-2473. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Otolaryngology, Speech, Language and Hearing Service Providers / Audiologist, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Allopathic & Osteopathic Physicians / Otolaryngology is the primary health care specialty. Neil Wangstrom Md Pc can be contacted via phone (219) 325-3770, or through Henrich, Robin M via phone (219) 325-3770.

Contact Information

Primary practice address
304 Detroit St La Porte IN 46350-2473
Phone: (219) 325-3770
Fax: (219) 325-8181
Website:
Map and Directions
Authorized official contact:
Name: Henrich, Robin M CMPC
Phone: (219) 325-3770

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 01038858 Indiana
Speech, Language and Hearing Service Providers / Audiologist 231H00000X 23002292A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 71001701A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 71001740A Indiana

Profile Details

NPI number 1043307978
LBN Legal business name Neil Wangstrom Md Pc
DBA Doing business as Northwest Indiana Ent Assoicates
Authorized official Henrich, Robin M CMPC
Entity Organization
Organization subpart 1 No
Enumeration date Oct 10th, 2006
Last updated Sep 29th, 2009 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043307978 NPPES
Indiana MEDICAID 100165330A
Indiana Other 000000105404
Indiana MEDICAID 200245050A
Indiana MEDICAID 200482190
Indiana MEDICAID 100165330

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