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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. NEIL WILLIAM WANGSTROM, M.D.

Active

Otolaryngology · LA PORTE, IN

Registration Details

NPI Number
1730189820
Provider Type
Individual
Gender
Male
NPI Issued
Jul 29, 2005 (20.772132150008 yrs)
Last Updated
Sep 16, 2020
Licenses
01038858 (IN)
01038858 (IN)
01038858 (IN)
01038858 (IN)
01038858 (IN)

Practice Information

Address
304 DETROIT ST
LA PORTE, IN, 463502497
Browse IN providers · Browse ZIP 46350
Phone
2193253770
Fax
2193258181
Primary Specialty
Otolaryngology
207Y00000X
Additional Specialty
Pediatric Otolaryngology
Additional Specialty
Otology & Neurotology
Additional Specialty
Otolaryngic Allergy
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.