| Goshen Medical Practice,llc | |
|
2240 Karisa Dr Suite1 Goshen IN 46526-6943 | |
| (574) 534-6757 | |
| (574) 537-0357 |
| Full Name | Goshen Medical Practice,llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2240 Karisa Dr, Goshen, Indiana |
| Authorized Official Name and Position | Dicky G Bhagat (SOLE PROPERITOR OF LLC) |
| Authorized Official Contact | 5745346757 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Goshen Medical Practice,llc 2240 Karisa Dr Suite1 Goshen IN 46526-6943 Ph: (574) 534-6757 | Goshen Medical Practice,llc 2240 Karisa Dr Suite1 Goshen IN 46526-6943 Ph: (574) 534-6757 |
| NPI Number | 1861582694 |
|---|---|
| Provider Enumeration Date | 10/13/2006 |
| Last Update Date | 02/22/2024 |
| Medicare PECOS PAC ID | 5193611309 |
|---|---|
| Medicare Enrollment ID | O20040225000272 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861582694 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 01054743A (Indiana) | Primary |
| Provider Name | Dicky G Bhagat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518960525 PECOS PAC ID: 1850287087 Enrollment ID: I20040225000496 |
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