| Internal Medicine Practice, Llc | |
|
1011 E. National Ave Brazil IN 47834 | |
| (812) 446-3278 | |
| (812) 446-3508 |
| Full Name | Internal Medicine Practice, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1011 E. National Ave, Brazil, Indiana |
| Authorized Official Name and Position | Camillo M Mendoza (DOCTOR) |
| Authorized Official Contact | 8124463278 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine Practice, Llc 1011 E. National Ave Brazil IN 47834 Ph: (812) 446-3278 | Internal Medicine Practice, Llc 1011 E. National Ave Brazil IN 47834 Ph: (812) 446-3278 |
| NPI Number | 1528387412 |
|---|---|
| Provider Enumeration Date | 05/18/2010 |
| Last Update Date | 07/10/2015 |
| Medicare PECOS PAC ID | 0547393902 |
|---|---|
| Medicare Enrollment ID | O20100805000351 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528387412 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 01049692 (Indiana) | Primary |
| 207R00000X | Internal Medicine | 01049698 (Indiana) | Secondary |
| Provider Name | Freya G Paje |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700859089 PECOS PAC ID: 0345385571 Enrollment ID: I20100226000579 |
| Provider Name | Camillo M Mendoza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023081395 PECOS PAC ID: 2062557606 Enrollment ID: I20100325000015 |
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