Provider Demographics
NPI:1730343328
Name:NORTHWEST ENDOCRINOLOGY & DIABETES PC
Entity type:Organization
Organization Name:NORTHWEST ENDOCRINOLOGY & DIABETES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NIHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:MUHREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-736-1758
Mailing Address - Street 1:270 E 90TH DR STE B
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-8102
Mailing Address - Country:US
Mailing Address - Phone:219-736-1758
Mailing Address - Fax:219-736-1717
Practice Address - Street 1:270 E 90TH DR STE B
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-8102
Practice Address - Country:US
Practice Address - Phone:219-736-1758
Practice Address - Fax:219-736-1717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-14
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01045632B174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000219451OtherANTHEM BLUE CROSS BLUE SHIELD
IN201042540Medicaid
IN201042540Medicaid
IN144270Medicare PIN