Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 01060618A | IN |
N | 207YP0228X | Pediatric Otolaryngology | 01060618A | IN |
N | 207YS0123X | Facial Plastic Surgeon | 01060618A | IN |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 01060618A | IN |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 01060618A | IN |
NPI | 1710986765 |
---|---|
Provider Name | Dr. Ryan C Cmejrek |
First Address | Merrillville, IN 46410-6381 |
Second Address | Merrillville, IN 46410-6381 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2005 |
Last Update Date | 22/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I32525 | (02) | IN |