| The Neuroclinic P C | |
|
130 Commerce Sq Michigan City IN 46360-3281 | |
| (219) 878-9870 | |
| (219) 878-9873 |
| Full Name | The Neuroclinic P C |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 130 Commerce Sq, Michigan City, Indiana |
| Authorized Official Name and Position | Nasar M Katariwala (OWNER) |
| Authorized Official Contact | 2198789870 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Neuroclinic P C 130 Commerce Sq Michigan City IN 46360-3281 Ph: (219) 878-9870 | The Neuroclinic P C 130 Commerce Sq Michigan City IN 46360-3281 Ph: (219) 878-9870 |
| NPI Number | 1003955683 |
|---|---|
| Provider Enumeration Date | 02/06/2007 |
| Last Update Date | 09/17/2014 |
| Medicare PECOS PAC ID | 5698872364 |
|---|---|
| Medicare Enrollment ID | O20070515000413 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003955683 | NPI | - | NPPES |
| 200381990 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 01056291A (Indiana) | Primary |
| Provider Name | Nasar Munir Katariwala |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356311310 PECOS PAC ID: 2163494576 Enrollment ID: I20040806000916 |
| Provider Name | Petronio Ilagan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639122047 PECOS PAC ID: 8224014410 Enrollment ID: I20080222000337 |
| Provider Name | Carrie Y Robison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548789118 PECOS PAC ID: 8628335767 Enrollment ID: I20171128003358 |
| Provider Name | Rebecca Lyn Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801466883 PECOS PAC ID: 0446648935 Enrollment ID: I20211103000713 |
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