| New Balance Occupational Medicine, Llc | |
|
1574 E 85th Ave Merrillville IN 46410 | |
| (219) 769-4400 | |
| (219) 795-1419 |
| Full Name | New Balance Occupational Medicine, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1574 E 85th Ave, Merrillville, Indiana |
| Authorized Official Name and Position | Oranu G Ibekie (MD) |
| Authorized Official Contact | 2197694400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Balance Occupational Medicine, Llc Po Box 10746 Merrillville IN 46411-0746 Ph: (219) 769-4400 | New Balance Occupational Medicine, Llc 1574 E 85th Ave Merrillville IN 46410 Ph: (219) 769-4400 |
| NPI Number | 1184921652 |
|---|---|
| Provider Enumeration Date | 02/18/2011 |
| Last Update Date | 04/24/2019 |
| Medicare PECOS PAC ID | 2062697220 |
|---|---|
| Medicare Enrollment ID | O20110503000596 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184921652 | NPI | - | NPPES |
| 201016650A | Medicaid | IN |
| Provider Name | Anupama Subramanian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740251321 PECOS PAC ID: 4789645516 Enrollment ID: I20041025000426 |
| Provider Name | Oranu Ibekie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134190713 PECOS PAC ID: 8921074311 Enrollment ID: I20051115000076 |
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