Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 12006616A | IN |
NPI | 1043291800 |
---|---|
Provider Name | Dr. Joseph Henry Lovasko |
First Address | Schererville, IN 46375-2656 |
Second Address | Schererville, IN 46375-2656 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2005 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000084418 | BC BS PROVIDER PIN NUMBER (01) | IN |
000000084419 | BC BS PROVIDER PIN NUMBER (01) | IN |
476023 | UNITED CONCORDIA NUMBER (01) | IN |
U426590 | (02) | IN |