| |
7345 Woodland Dr Ste 1 Indianapolis IN 46278-1737 | |
(317) 762-4025 | |
(317) 759-4003 |
Full Name | |
---|---|
Speciality | Internal Medicine |
Location | 7345 Woodland Dr Ste 1, Indianapolis, Indiana |
Authorized Official Name and Position | Leo Obrique (VICE PRESIDENT OF TECHNOLOGY) |
Authorized Official Contact | 3175619125 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
7345 Woodland Dr Ste 1 Indianapolis IN 46278-1737 Ph: (877) 843-2351 | 7345 Woodland Dr Ste 1 Indianapolis IN 46278-1737 Ph: (317) 762-4025 |
NPI Number | 1952979288 |
---|---|
Provider Enumeration Date | 06/14/2021 |
Last Update Date | 04/18/2022 |
Medicare PECOS PAC ID | 8820476070 |
---|---|
Medicare Enrollment ID | O20220601000375 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952979288 | NPI | - | NPPES |
01054614A | Other | IN | INTERNAL MEDICINE LICENSE - IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Jude Jimmy Momodu |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1912924549 PECOS PAC ID: 5092709154 Enrollment ID: I20040412001145 |
Provider Name | Prabhjot Pannu |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1447295399 PECOS PAC ID: 8729229265 Enrollment ID: I20230321000296 |
Moazzam Habib Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9240 N Meridian St, Suite 240, Indianapolis, IN 46260 Phone: 317-571-0030 Fax: 317-571-0031 | |
Franciscan Health Indianapolis & Mooresville Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5230a East Stop 11 Road, Suite 250, Indianapolis, IN 46237 Phone: 317-528-8921 Fax: 317-528-6916 | |
Evernorth Care Providers - Delaware Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8888 Keystone Xing Ste 1300, Indianapolis, IN 46240 Phone: 773-292-4800 Fax: 312-564-4059 | |
Cadience Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5602 Caito Dr, Indianapolis, IN 46226 Phone: 901-235-2065 |