ALBERT WILLARDO MD (NPI# 1619155926) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619155926 |
| Entity Type | Organization |
| Organization Name | ALBERT WILLARDO MD |
| Practice Address |
7150 Indianapolis Blvd Hammond IN 46324-2245 |
| Mailing Address |
55 E 86th Ave Po Box 10645 Merrillville IN 46410-6382 |
| Practice Telephone | 2198452030 |
| Practice Fax Number | 2199890257 |
| Mailing Telephone | 2197691670 |
| Mailing Fax Number | 2197386714 |
| Enumeration Date | 2008-02-08 |
| Last Update Date | 2008-02-08 |
| Authorized Official Name | ALBERT WILLARDO (OWNER/PHYSICIAN) |
| Authorized Official Telephone | 2198452030 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 01020554 | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100161690A | 05 |
| Street Address |
7150 INDIANAPOLIS BLVD |
| City | HAMMOND |
| State | IN |
| Zip Code | 46324-2245 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
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| 1679049779 | Secure Dental Viii | Dentist | 7905 Indianapolis Blvd, Indianan, IN 46324 | 2018-10-17 |
| 1710317615 | Christopher Keown-belous | Marriage & Family Therapist | 7030 Indianapolis Blvd, Hammond, IN 46324 | 2013-11-14 |
| 1316296114 | Planned Parenthood of Indiana Hammond | Clinic/Center | 7131 Indianapolis Blvd., Hammond, IN 46324 | 2012-09-07 |
| 1427343862 | Amanda Rose Popovich | Behavioral Analyst | 7110 Magoun Avenue, Hammond, IN 46324 | 2011-06-14 |
| 1588804751 | Tanesha Marnise Williams | Technician | 5831 Erie St, Hammond, IN 46324 | 2009-03-02 |
| 1417039652 | Debra Antoinette Petersen | Nurse Practitioner | 7131 Indianapolis Blvd, Hammond, IN 46324 | 2006-10-19 |
| 1568455467 | Elisabeth Cleary Shearon | Pathology | Alvero Clinical Laboratories, 3434 Interstate Plaza Dr, Hammond, IN 46324 | 2005-08-25 |
| 1578958278 | Aditya Shah | Family Medicine | 6920 Indianapolis Blvd, Hammond, IN 46324 | 2015-03-31 |
| 1770928509 | Hammond Dental Group LLC | Dentist | 6414 Calumet Ave, Hammond, IN 46324 | 2013-05-07 |
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| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.