Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 01026587A | IN |
NPI | 1063493542 |
---|---|
Provider Name | Ramakrishnan P Unni |
First Address | Merrillville, IN 46410 |
Second Address | Merrillville, IN 46410 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2005 |
Last Update Date | 20/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0091108094 | BLUE SHIELD OF ILLINOIS (01) | IL |
100158110A | (05) | IN |
E05524 | (02) | IN |