| Midwest Clinic Pc | |
|
13 W Us Hwy 30 Midwest Clinic Schererville IN 46375 | |
| (219) 865-0918 | |
| (219) 864-8332 |
| Full Name | Midwest Clinic Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 13 W Us Hwy 30, Schererville, Indiana |
| Authorized Official Name and Position | Mohammed Abdul Raoof Siddiqui (PRESIDENT) |
| Authorized Official Contact | 2198650918 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Clinic Pc 13 W Us Hwy 30 Schererville IN 46375 Ph: (219) 865-0918 | Midwest Clinic Pc 13 W Us Hwy 30 Midwest Clinic Schererville IN 46375 Ph: (219) 865-0918 |
| NPI Number | 1093801052 |
|---|---|
| Provider Enumeration Date | 10/05/2006 |
| Last Update Date | 10/14/2015 |
| Medicare PECOS PAC ID | 5799755906 |
|---|---|
| Medicare Enrollment ID | O20151022001821 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093801052 | NPI | - | NPPES |
| 100356480D | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 01041447 (Indiana) | Primary |
| Provider Name | Mohammed Abdulraoof Siddiqui |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962598086 PECOS PAC ID: 1456321660 Enrollment ID: I20040727000478 |
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