NEIL WANGSTROM MD PC NPI 1043307978

NPI Information

  • NPI: 1043307978
  • Provider Name: NEIL WANGSTROM MD PC
  • Classification: Otolaryngology - 207Y00000X
  • Entity Type: Organization
  • Former Legal Business Name: NORTHWEST INDIANA ENT ASSOICATES
  • Address: 304 DETROIT ST
    LA PORTE, IN
    ZIP 46350
  • Phone: (219) 325-3770

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NPI Details

NEIL WANGSTROM MD PC is an otolaryngology in La Porte, IN. The provider is an otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. NEIL WANGSTROM MD PC NPI is 1043307978. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Northwest Indiana Ent Assoicates.

The provider's business location address is:

304 DETROIT ST
LA PORTE, IN
ZIP 46350-473
Phone: (219) 325-3770
Fax: (219) 325-8181

The provider's authorized official is Robin M Henrich .
The authorized official title is Practice Manager and has the following contact phone number (219) 325-3770.

The enumeration date for this NPI number is 10/10/2006 and was last updated on 9/29/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1231H00000XAudiologist23002292AINDIANANo
2363L00000XNurse Practitioner71001701AINDIANANo
3363L00000XNurse Practitioner71001740AINDIANANo
4207Y00000XOtolaryngology01038858INDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1Q60281MEDICARE UPININDIANA
2100165330AMEDICAIDINDIANA
3200482190MEDICAIDINDIANA
4000000105404OTHERINDIANAANTHEM
5224040CMEDICARE PININDIANA
6224040MEDICARE PININDIANA
7100165330MEDICAIDINDIANA
8224040AMEDICARE PININDIANA
9200245050AMEDICAIDINDIANA
10224040DDMEDICARE PININDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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