| |
303 W 89th Ave, Suite E4, Merrillville, IN 46410-6294 | |
(219) 769-8989 | |
(219) 756-6389 |
Full Name | |
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Type | Facility |
Speciality | Ophthalmology |
Location | 303 W 89th Ave, Merrillville, Indiana |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1073646089 | NPI | - | NPPES |
000000105018 | Other | IN | ANTHEM |
Taxonomy | Type | License (State) | Status |
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152W00000X | Optometrist | (* (Not Available)) | Primary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Provider Name | David G Gross |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1346373313 PECOS PAC ID: 6507830502 Enrollment ID: I20100708000196 |
Provider Name | Jeffrey L Nelson |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1235459132 PECOS PAC ID: 7517184724 Enrollment ID: I20140812002298 |
Mailing Address | Practice Location Address |
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303 W 89th Ave, Suite E4, Merrillville, IN 46410-6294 Ph: (219) 769-8989 | 303 W 89th Ave, Suite E4, Merrillville, IN 46410-6294 Ph: (219) 769-8989 |