Nwi Mdvip LLC
NPI #1538877972 in Crown Point, Indiana
Provider Information
- NPI Number
- 1538877972
- Entity Type
- Organization
- Organization Name
- Nwi Mdvip LLC
- Primary Specialty
- Family Medicine
- Enumeration Date
- Nov 14, 2022
- Last Updated
- Nov 14, 2022
Practice Location
- Address
- 9150 E 109TH AVE STE 2B
- City
- Crown Point
- State
- Indiana
- ZIP Code
- 46307-7686
- Phone
- (219) 213-2947
Authorized Official
- Name
- BRENT A JACOBUS, DO
- Title
- OWNER
- Phone
- (219) 306-0752
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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