| Medical Center For Joint Restoration And Regenerative Medicine, Llc | |
|
3900 S Walnut St Ste A Bloomington IN 47401-7331 | |
| (812) 822-1516 | |
| Not Available |
| Full Name | Medical Center For Joint Restoration And Regenerative Medicine, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3900 S Walnut St Ste A, Bloomington, Indiana |
| Authorized Official Name and Position | Erika Esther Giron (OWNER) |
| Authorized Official Contact | 8128221516 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Center For Joint Restoration And Regenerative Medicine, Llc 3900 S Walnut St Ste A Bloomington IN 47401-7331 Ph: (812) 822-1516 | Medical Center For Joint Restoration And Regenerative Medicine, Llc 3900 S Walnut St Ste A Bloomington IN 47401-7331 Ph: (812) 822-1516 |
| NPI Number | 1194316596 |
|---|---|
| Provider Enumeration Date | 01/28/2021 |
| Last Update Date | 06/29/2021 |
| Medicare PECOS PAC ID | 3779998695 |
|---|---|
| Medicare Enrollment ID | O20210226000335 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194316596 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Debra Hermann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992345201 PECOS PAC ID: 1658786587 Enrollment ID: I20210226000425 |
| Provider Name | Liang Lu Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396316550 PECOS PAC ID: 3577961952 Enrollment ID: I20211015000980 |
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