Neil Wangstrom Md Pc is a
Otolaryngology based in La Porte, Indiana. Neil Wangstrom Md Pc is licensed to practice in Indiana (license number 01038858) and their current practice location is
304 Detroit St, La Porte, Indiana. It can be reached at their office (for appointments etc.) via phone at
(219) 325-3770.
NPI number for Neil Wangstrom Md Pc is 1043307978 and their current mailing address is 304 Detroit St, La Porte, Indiana. Neil Wangstrom Md Pc
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1043307978.
Healthcare Provider's Profile
Full Name | Neil Wangstrom Md Pc |
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Type | Facility |
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Speciality | Otolaryngology |
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Location | 304 Detroit St, La Porte, Indiana |
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Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
NPI Data:
- NPI Number: 1043307978
- Provider Enumeration Date: 10/10/2006
- Last Update Date: 09/29/2009
Medical Identifiers
Medical identifiers for Neil Wangstrom Md Pc such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1043307978 | NPI | - | NPPES |
100165330A | Medicaid | IN | |
000000105404 | Other | IN | ANTHEM |
200245050A | Medicaid | IN | |
200482190 | Medicaid | IN | |
100165330 | Medicaid | IN | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
231H00000X | Audiologist | 23002292A (Indiana) | Secondary |
363L00000X | Nurse Practitioner | 71001701A (Indiana) | Secondary |
363L00000X | Nurse Practitioner | 71001740A (Indiana) | Secondary |
207Y00000X | Otolaryngology | 01038858 (Indiana) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Neil Wangstrom Md Pc is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Neil Wangstrom Md Pc 304 Detroit St, La Porte, IN 46350-2473 Ph: (219) 325-3770 | Neil Wangstrom Md Pc 304 Detroit St, La Porte, IN 46350-2473 Ph: (219) 325-3770 |
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