Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 01047617A | IN |
N | 208200000X | Surgeon | 036-091202 | IL |
N | 208600000X | Surgeon | 036-091202 | IL |
N | 2086S0105X | Surgery of the Hand | 01047617A | IN |
NPI | 1891843520 |
---|---|
Provider Name | Jack Gelman |
First Address | Munster, IN 46321-0329 |
Second Address | Munster, IN 46321-2818 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2007 |
Last Update Date | 15/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G15213 | (02) |