Dr Indira Moodumane, MD | |
809 Meyers Baker Rd, Suite 1, London, KY 40741-3025 | |
(606) 864-7337 | |
(606) 878-3257 |
Full Name | Dr Indira Moodumane |
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Gender | Female |
Speciality | Pediatrics |
Location | 809 Meyers Baker Rd, London, Kentucky |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1639181340 | NPI | - | NPPES |
64039019 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 36054 (Kentucky) | Primary |
174400000X | Specialist | 36054 (Kentucky) | Secondary |
Entity Name | Grace Community Health Center, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1568625648 PECOS PAC ID: 3870654064 Enrollment ID: O20081211000571 |
Mailing Address | Practice Location Address |
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Dr Indira Moodumane, MD Po Box 689, London, KY 40743-0689 Ph: (606) 864-7337 | Dr Indira Moodumane, MD 809 Meyers Baker Rd, Suite 1, London, KY 40741-3025 Ph: (606) 864-7337 |
Muhammad Ali, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 378 Thompson Poynter Rd, London, KY 40741 Phone: 606-877-3990 Fax: 606-877-3993 | |
Khalid H Memon, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 378 Thompson Poynter Rd, London, KY 40741 Phone: 606-877-3990 Fax: 606-877-3993 | |
Dr. Indra Rastogi, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 202 W 7th St, Suite 200, London, KY 40741 Phone: 606-878-8100 Fax: 606-864-7878 | |
Hassan Mahmood, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 378 Thompson Poynter Rd, London, KY 40741 Phone: 606-877-3990 Fax: 606-877-3993 | |
Piper Seyfrit, Pediatrics Medicare: Medicare Enrolled Practice Location: 803 Meyers Baker Rd Ste 200, London, KY 40741 Phone: 606-878-3240 |