Provider Demographics
NPI:1972599421
Name:MESSINA, MICHAEL J (DO)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:MESSINA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1040 SIERRA DR
Mailing Address - Street 2:STE 400
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-7240
Mailing Address - Country:US
Mailing Address - Phone:317-528-4248
Mailing Address - Fax:317-865-8314
Practice Address - Street 1:3500 FRANCISCAN WAY STE 300
Practice Address - Street 2:
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-0021
Practice Address - Country:US
Practice Address - Phone:219-879-6531
Practice Address - Fax:219-878-8331
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2021-03-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN02002286A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200314150Medicaid
IN200314150Medicaid
E61894Medicare UPIN