| Family Medical Associates P C | |
|
1428 N Gardner St Scottsburg IN 47170-8720 | |
| (812) 752-4001 | |
| (812) 752-4654 |
| Full Name | Family Medical Associates P C |
|---|---|
| Speciality | Family Medicine |
| Location | 1428 N Gardner St, Scottsburg, Indiana |
| Authorized Official Name and Position | Dhamy Sivamohan (PRESIDENT) |
| Authorized Official Contact | 8125950280 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medical Associates P C 1428 N Gardner St Scottsburg IN 47170-8720 Ph: (812) 752-4001 | Family Medical Associates P C 1428 N Gardner St Scottsburg IN 47170-8720 Ph: (812) 752-4001 |
| NPI Number | 1548357775 |
|---|---|
| Provider Enumeration Date | 10/09/2006 |
| Last Update Date | 10/15/2014 |
| Medicare PECOS PAC ID | 0749279768 |
|---|---|
| Medicare Enrollment ID | O20070213000228 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548357775 | NPI | - | NPPES |
| 200447040A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 01055482A (Indiana) | Primary |
| Provider Name | Dhamyanthi Sivamohan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326146580 PECOS PAC ID: 9133118151 Enrollment ID: I20040506000946 |
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