| |
2040 N Shadeland Ave Suite 300 Indianapolis IN 46219-1711 | |
(317) 355-3232 | |
(317) 355-6042 |
Full Name | |
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Speciality | Family Medicine |
Location | 2040 N Shadeland Ave, Indianapolis, Indiana |
Authorized Official Name and Position | Jeffery Kirkham (CFO) |
Authorized Official Contact | 3173554887 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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3826 Solutions Ctr Chicago IL 60677-3008 Ph: (317) 355-5837 | 2040 N Shadeland Ave Suite 300 Indianapolis IN 46219-1711 Ph: (317) 355-3232 |
NPI Number | 1477626398 |
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Provider Enumeration Date | 11/16/2006 |
Last Update Date | 10/13/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1477626398 | NPI | - | NPPES |
100121170A | Medicaid | IN | |
5942684 | Other | IN | AETNA |
000000226100 | Other | IN | ANTHEM |
000000107139 | Other | IN | ANTHEM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
207V00000X | Obstetrics & Gynecology | (* (Not Available)) | Secondary |
208000000X | Pediatrics | (* (Not Available)) | Secondary |
Moazzam Habib Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9240 N Meridian St, Suite 240, Indianapolis, IN 46260 Phone: 317-571-0030 Fax: 317-571-0031 | |
Franciscan Health Indianapolis & Mooresville Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5230a East Stop 11 Road, Suite 250, Indianapolis, IN 46237 Phone: 317-528-8921 Fax: 317-528-6916 | |
Evernorth Care Providers - Delaware Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8888 Keystone Xing Ste 1300, Indianapolis, IN 46240 Phone: 773-292-4800 Fax: 312-564-4059 | |
Cadience Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5602 Caito Dr, Indianapolis, IN 46226 Phone: 901-235-2065 |