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Northwest Center Medical Services Corp.
Clinical Genetics (M.D.) Physician in Gary, Indiana
NPI 1942488754

Northwest Center Medical Services Corp. is a Clinical Genetics (M.D.) Physician based in Gary, IN and is specialized in Clinical Genetics (M.D.). Northwest Center Medical Services Corp. practices in Gary, IN. The NPI Number for Northwest Center Medical Services Corp. is 1942488754 and holds a License No. 01034255A (Indiana).

The current practice location address for Northwest Center Medical Services Corp. is 3400 Broadway, Gary, IN and can be reached out via phone at 219-980-6560 and via fax at 219-980-6693.

Location: 3400 Broadway, Gary, IN, 46408-1101
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1942488754
Provider Name
Northwest Center Medical Services Corp.
Credential
Provider Entity Type
Organization
Address
3400 Broadway, Gary, IN, 46408-1101
Phone Number
219-980-6560
Fax Number
219-980-6693
Provider Enumeration Date
02/04/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000000079455 01 BLUE CROSS BLUE SHIELD PIN#
370019259 01 IN MEDICARE RAILROAD PIN
911-15448 01 BLUE CROSS BLUES SHIELD OF IL PROVIDER#
100213240A 05 IN
2047365 01 AETNA PROVIDER NUMBER
institution
Provider Business Practice Location Address Details
Address
3400 Broadway
City
Gary
State
Indiana
Zip
46408-1101
Phone Number
219-980-6560
Fax Number
219-980-6693
person
Provider Business Mailing Address Details
Address
3400 Broadway
City
Gary
State
Indiana
Zip
46408-1101
Phone Number
219-980-6560
Fax Number
219-980-6693
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Medical Genetics
Speciality
Clinical Genetics (M.D.)
Taxonomy
207SG0201X
License No.
01034255A (Indiana)
Definition
A clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders.
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