Northwest Indiana Podiatry Clinic, Llc

LBN: Northwest Indiana Podiatry Clinic, Llc
Northwest Indiana Podiatry Clinic, Llc is an health care organization with primary practice located at 3100 45Th Ave , Highland IN 46322. The organization recently has 7 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Assistant, Podiatric, Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Public Medicine, Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, Podiatric Medicine & Surgery Service Providers / Radiology, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, Podiatric Medicine & Surgery Service Providers / Foot Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is the primary health care specialty. Northwest Indiana Podiatry Clinic, Llc can be contacted via phone (219) 922-0510, or through Massuda, Fortunee via phone (773) 233-3800.

Contact Information

Primary practice address
3100 45Th Ave Highland IN 46322
Phone: (219) 922-0510
Fax: (219) 923-4594
Website:
Map and Directions
Authorized official contact:
Name: Massuda, Fortunee Doctor of Podiatric Medicine (DPM)
Phone: (773) 233-3800

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Assistant, Podiatric 211D00000X
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X Indiana
Podiatric Medicine & Surgery Service Providers / Public Medicine 213EP0504X
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine 213EP1101X
Podiatric Medicine & Surgery Service Providers / Radiology 213ER0200X
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X

Profile Details

NPI number 1609072677
LBN Legal business name Northwest Indiana Podiatry Clinic, Llc
DBA Doing business as
Authorized official Massuda, Fortunee Doctor of Podiatric Medicine (DPM)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 26th, 2007
Last updated Nov 12th, 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 1609072677 NPPES
Indiana MEDICAID 200124730C
Indiana Other 90001145

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