Lake Surgical Associates, LLC

NPI #1275673865 in Munster, Indiana

Provider Information

NPI Number: 1275673865
Entity Type: Organization
Organization Name: Lake Surgical Associates, LLC
Primary Specialty: Surgery
Enumeration Date: Feb 6, 2007
Last Updated: Mar 19, 2008

Practice Location

Address: 10110 DONALD POWERS DR.
Address 2: STE. 202
City: Munster
State: Indiana
ZIP Code: 46321
Phone: (219) 922-0222

Authorized Official

Name: DR. RUSSELL W PELLAR, M.D.
Title: DOCTOR
Phone: (219) 922-0222

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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