Provider Demographics
NPI:1659300317
Name:CALUMET INTERNISTS, P.C.
Entity type:Organization
Organization Name:CALUMET INTERNISTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BERNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-931-7400
Mailing Address - Street 1:5500 S HOHMAN AVE
Mailing Address - Street 2:SUITE 1D
Mailing Address - City:HAMMOND
Mailing Address - State:IN
Mailing Address - Zip Code:46320-1965
Mailing Address - Country:US
Mailing Address - Phone:219-931-7400
Mailing Address - Fax:219-933-3469
Practice Address - Street 1:5500 S HOHMAN AVE
Practice Address - Street 2:SUITE 1D
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46320-1965
Practice Address - Country:US
Practice Address - Phone:219-931-7400
Practice Address - Fax:219-933-3469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN496190Medicare ID - Type Unspecified