Dr Daniel J Livera, MD | |
428 W Votaw St, Portland, IN 47371-1302 | |
(260) 726-8822 | |
Not Available |
Full Name | Dr Daniel J Livera |
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Gender | Male |
Speciality | Family Medicine |
Location | 428 W Votaw St, Portland, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1043838543 | NPI | - | NPPES |
M12240475 | Other | IN | MEDICARE PTAN |
300040515 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 01089292A (Indiana) | Primary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
Entity Name | Indiana University Health Ball Memorial Physicians Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1235455544 PECOS PAC ID: 9537072640 Enrollment ID: O20031110000505 |
Mailing Address | Practice Location Address |
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Dr Daniel J Livera, MD 250 N Shadeland Ave, Indianapolis, IN 46219-4959 Ph: () - | Dr Daniel J Livera, MD 428 W Votaw St, Portland, IN 47371-1302 Ph: (260) 726-8822 |
J Frank Vormohr, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 430 W Votaw St, Portland, IN 47371 Phone: 260-726-7616 Fax: 260-726-8165 | |
David M Brown, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 500 W Votaw St, Portland, IN 47371 Phone: 260-726-7131 | |
Jerry Warren Whetzel, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 430 W Votaw St, Portland, IN 47371 Phone: 260-726-7616 Fax: 260-726-8165 | |
Stephanie C Sharpe, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 430 W Votaw St, Portland, IN 47371 Phone: 260-726-9027 Fax: 260-726-9529 | |
Dr. Som Dutt Tyagi, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 500 W Votaw St, Portland, IN 47371 Phone: 260-726-7131 | |
Leonard J Green, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 428 W Votaw St, Suite A, Portland, IN 47371 Phone: 260-726-8822 Fax: 260-726-7857 |