| Elite Internal Medicine Pc | |
|
1242 Surrey Ct Crown Point IN 46307-5239 | |
| (219) 769-3550 | |
| (219) 769-2642 |
| Full Name | Elite Internal Medicine Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1242 Surrey Ct, Crown Point, Indiana |
| Authorized Official Name and Position | Raenette Napier (OFFICE MANAGER) |
| Authorized Official Contact | 2197693550 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Internal Medicine Pc Po Box 438 Crown Point IN 46308-0438 Ph: (219) 769-3550 | Elite Internal Medicine Pc 1242 Surrey Ct Crown Point IN 46307-5239 Ph: (219) 769-3550 |
| NPI Number | 1528228301 |
|---|---|
| Provider Enumeration Date | 06/14/2008 |
| Last Update Date | 12/05/2012 |
| Medicare PECOS PAC ID | 5799857835 |
|---|---|
| Medicare Enrollment ID | O20080707000024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528228301 | NPI | - | NPPES |
| 200901600A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 01034369A (Indiana) | Primary |
| Provider Name | Zafar U Khalid |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689657975 PECOS PAC ID: 9133108699 Enrollment ID: I20040717000285 |
| Provider Name | Boyann Bea Bonjean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376184010 PECOS PAC ID: 5991912602 Enrollment ID: I20200102000613 |
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