Seth Bouwer

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Dyer, IN

NPI 1285441964 · NPPES record last updated Jan 9, 2025

Key facts

NPI
1285441964
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
1040 Killarney Dr
Dyer, IN 46311-1293
Phone
(219) 628-6623
NPI assigned
Dec 16, 2024
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

1040 Killarney Dr
Dyer, IN 46311-1293

Mailing address

1040 Killarney Dr
Dyer, IN 46311-1293
Phone (219) 628-6623

Other providers in Dyer, IN

All providers in Dyer, IN · Student in an Organized Health Care Education/Training Program in Indiana

Sources for this page

Verify at the official NPI Registry.