Michael J Nommensen, MD | |
1573 N Cline Ave, Griffith, IN 46319-1567 | |
(219) 838-2311 | |
Not Available |
Full Name | Michael J Nommensen |
---|---|
Gender | Male |
Speciality | Family Medicine |
Location | 1573 N Cline Ave, Griffith, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1831105808 | NPI | - | NPPES |
000000651853 | Other | IN | ANTHEM |
036121930 | Medicaid | IL | |
200976940 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 036-121930 (Illinois) | Secondary |
207Q00000X | Family Medicine | 01066790A (Indiana) | Primary |
Entity Name | Eskenazi Medical Group Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1730451063 PECOS PAC ID: 4284546813 Enrollment ID: O20031103000440 |
Mailing Address | Practice Location Address |
---|---|
Michael J Nommensen, MD 1040 Sierra Drive, Suite 400, Greenwood, IN 46143-7241 Ph: (317) 528-4886 | Michael J Nommensen, MD 1573 N Cline Ave, Griffith, IN 46319-1567 Ph: (219) 838-2311 |
Charles Mok Jr., DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1573 N Cline Ave, Griffith, IN 46319 Phone: 219-838-2312 Fax: 219-972-7177 | |
Dr. Mohamed Monzer Krad, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 315 W 35th Ave, Griffith, IN 46319 Phone: 219-923-9200 Fax: 219-972-1557 |