My Mobile Diagnostics Llc | |
429 E Vermont St Ste 110 Indianapolis IN 46202-3685 | |
(317) 559-0950 | |
(317) 936-3028 |
Full Name | My Mobile Diagnostics Llc |
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Speciality | Family Medicine |
Location | 429 E Vermont St Ste 110, Indianapolis, Indiana |
Authorized Official Name and Position | Steven C Martin (PARTNER) |
Authorized Official Contact | 3176706635 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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My Mobile Diagnostics Llc 7007 Graham Rd Ste 215 Indianapolis IN 46220-4063 Ph: (317) 559-0950 | My Mobile Diagnostics Llc 429 E Vermont St Ste 110 Indianapolis IN 46202-3685 Ph: (317) 559-0950 |
NPI Number | 1033628680 |
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Provider Enumeration Date | 09/27/2017 |
Last Update Date | 04/21/2020 |
Medicare PECOS PAC ID | 8022449669 |
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Medicare Enrollment ID | O20200514000795 |
Identifier | Type | State | Issuer |
---|---|---|---|
1033628680 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Joe Banks |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1154508075 PECOS PAC ID: 7113098765 Enrollment ID: I20080625000389 |
Provider Name | Ryan Matthew Pickell |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1578943460 PECOS PAC ID: 3870805294 Enrollment ID: I20190904001423 |
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