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TERRY EBERT MD INC NPI 1417173717


NPI Information

NPI: 1417173717
Provider Name: TERRY EBERT, MD, INC
Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

Address:
509 RIDGE RD
SUITE 1
MUNSTER, IN
ZIP 46321
Phone: (219) 836-1050
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TERRY EBERT, MD, INC is a medical specialty clinic center in Munster, IN. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). TERRY EBERT, MD, INC NPI is 1417173717. The provider is registered as an organization entity type.

The provider's business location address is:

509 RIDGE RD
SUITE 1
MUNSTER, IN
ZIP 46321-643
Phone: (219) 836-1050
Fax: (219) 836-4969

The provider's authorized official is Terry W Ebert .
The authorized official title is President and has the following contact phone number (219) 836-1050.

The enumeration date for this NPI number is 4/17/2007 and was last updated on 3/7/2023.


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
1261QM2500XClinic/CenterMedical Specialty01022150AINDIANAYes

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
101022150AOTHERPHYSICIAN LICENSE NUMBER
250001124AOTHERINDIANACORPORATION REGISTRATION

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: 5/5/2024

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