| Bangura Medical Services,pc | |
|
5 Executive Dr Ste G Lafayette IN 47905-4867 | |
| (765) 448-4646 | |
| (765) 448-4791 |
| Full Name | Bangura Medical Services,pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5 Executive Dr Ste G, Lafayette, Indiana |
| Authorized Official Name and Position | Luella Bangura (PRESIDENT/OWNER) |
| Authorized Official Contact | 7654477941 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bangura Medical Services,pc 13 S Brookfield Dr Lafayette IN 47905-7658 Ph: (765) 447-7941 | Bangura Medical Services,pc 5 Executive Dr Ste G Lafayette IN 47905-4867 Ph: (765) 448-4646 |
| NPI Number | 1902814049 |
|---|---|
| Provider Enumeration Date | 08/04/2006 |
| Last Update Date | 12/11/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902814049 | NPI | - | NPPES |
| 200421310A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 01045193A (Indiana) | Primary |
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