Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MT195032 | PA |
N | 111NI0900X | Internist | MT195032 | PA |
Y | 207RC0200X | Critical Care Medicine | 01075562A | IN |
NPI | 1053548495 |
---|---|
Provider Name | Michael Christopher Hansen |
First Address | Chesterton, IN 46304-8708 |
Second Address | Valparaiso, IN 46383-8947 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2009 |
Last Update Date | 17/03/2018 |