Basic Information
| Provider Information | |||||||||
| NPI: | 1811987688 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ARTIS | ||||||||
| FirstName: | ANDRE | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5800 BROADWAY | ||||||||
| Address2: | SUITE A-J | ||||||||
| City: | MERRILLVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 464102601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2198849180 | ||||||||
| FaxNumber: | 2198849280 | ||||||||
| Practice Location | |||||||||
| Address1: | 5800 BROADWAY | ||||||||
| Address2: | SUITE A-J | ||||||||
| City: | MERRILLVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 464102601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2198849180 | ||||||||
| FaxNumber: | 2198849280 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2005 | ||||||||
| LastUpdateDate: | 10/05/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 01037773 | IN | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0000X | 01037773 | IN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.