| My Mobile Md Psychiatric Services Llc | |
|
429 E Vermont St Ste 110 Indianapolis IN 46202-3685 | |
| (317) 559-0950 | |
| Not Available |
| Full Name | My Mobile Md Psychiatric Services Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 429 E Vermont St Ste 110, Indianapolis, Indiana |
| Authorized Official Name and Position | Steven Martin (CEO) |
| Authorized Official Contact | 3176706635 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| My Mobile Md Psychiatric Services Llc Po Box 586 Galloway OH 43119-0586 Ph: () - | My Mobile Md Psychiatric Services Llc 429 E Vermont St Ste 110 Indianapolis IN 46202-3685 Ph: (317) 559-0950 |
| NPI Number | 1528712452 |
|---|---|
| Provider Enumeration Date | 02/09/2022 |
| Last Update Date | 02/09/2022 |
| Certification Date | 02/09/2022 |
| Medicare PECOS PAC ID | 9638564750 |
|---|---|
| Medicare Enrollment ID | O20220328000211 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528712452 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Olaniyi Osuntokun |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548375058 PECOS PAC ID: 9739362633 Enrollment ID: I20110331000119 |
| Provider Name | Patricia Mae Browning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760785091 PECOS PAC ID: 9234306796 Enrollment ID: I20120124000602 |
| Provider Name | Andrea E Tennancour |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356866834 PECOS PAC ID: 9537432968 Enrollment ID: I20170907001350 |
| Provider Name | Mia Stowe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699243089 PECOS PAC ID: 3173866399 Enrollment ID: I20190509002490 |
| Provider Name | Chenai M Mvundura |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407405756 PECOS PAC ID: 1759715162 Enrollment ID: I20191218000171 |
| Provider Name | Jimmy L Chenowith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881353415 PECOS PAC ID: 6002292323 Enrollment ID: I20221010001998 |
| Provider Name | Justin Sweney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790479194 PECOS PAC ID: 2668832080 Enrollment ID: I20230718000260 |
| Provider Name | Olivia Donkor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689451189 PECOS PAC ID: 8224476551 Enrollment ID: I20240405002023 |
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