| Monticello Podiatry Llc | |
|
101 W Broadway St Monticello IN 47960-2110 | |
| (765) 420-2850 | |
| Not Available |
| Full Name | Monticello Podiatry Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 101 W Broadway St, Monticello, Indiana |
| Authorized Official Name and Position | Murtuza Peerbhai (PRINCIPAL) |
| Authorized Official Contact | 7654202850 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Monticello Podiatry Llc 101 Broadway Monticello IN 47960 Ph: (765) 420-2850 | Monticello Podiatry Llc 101 W Broadway St Monticello IN 47960-2110 Ph: (765) 420-2850 |
| NPI Number | 1154626661 |
|---|---|
| Provider Enumeration Date | 01/13/2011 |
| Last Update Date | 04/15/2013 |
| Medicare PECOS PAC ID | 7214107580 |
|---|---|
| Medicare Enrollment ID | O20110823000904 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154626661 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | #07001110A (Indiana) | Primary |
| Provider Name | Murtuza A Peerbhai |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1740316124 PECOS PAC ID: 6305971755 Enrollment ID: I20101006000659 |
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