| Family Medicine Associates, Llc | |
|
5857 Broadway Merrillville IN 46410-2666 | |
| (219) 884-4450 | |
| (212) 884-4418 |
| Full Name | Family Medicine Associates, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 5857 Broadway, Merrillville, Indiana |
| Authorized Official Name and Position | Augustine Izah (OWNER) |
| Authorized Official Contact | 2198844450 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medicine Associates, Llc Po Box 10606 Merrillville IN 46411-0606 Ph: (219) 884-4450 | Family Medicine Associates, Llc 5857 Broadway Merrillville IN 46410-2666 Ph: (219) 884-4450 |
| NPI Number | 1659577146 |
|---|---|
| Provider Enumeration Date | 06/22/2007 |
| Last Update Date | 10/28/2013 |
| Medicare PECOS PAC ID | 3274569207 |
|---|---|
| Medicare Enrollment ID | O20050712000301 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659577146 | NPI | - | NPPES |
| 200523670A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 01042994 (Indiana) | Primary |
| Provider Name | Augustine Ikechukwa Izah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760476303 PECOS PAC ID: 0547296576 Enrollment ID: I20050712000617 |
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