Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 010-33430 | IN |
NPI | 1114012655 |
---|---|
Provider Name | Victorio K O'yek |
First Address | Valparaiso, IN 46383-2801 |
Second Address | Merrillville, IN 46410 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 30/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100349760 | (05) | IN |
E05520 | (02) |