| Willowcreek Medical Center | |
|
3156 Willowcreek Rd Portage IN 46368-4424 | |
| (219) 762-4999 | |
| Not Available |
| Full Name | Willowcreek Medical Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 3156 Willowcreek Rd, Portage, Indiana |
| Authorized Official Name and Position | Gaurav Kumar (OWNER) |
| Authorized Official Contact | 2197624999 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Willowcreek Medical Center 2700 Valparaiso St # 2001 Valparaiso IN 46383-3123 Ph: () - | Willowcreek Medical Center 3156 Willowcreek Rd Portage IN 46368-4424 Ph: (219) 762-4999 |
| NPI Number | 1487949889 |
|---|---|
| Provider Enumeration Date | 06/14/2011 |
| Last Update Date | 05/28/2020 |
| Medicare PECOS PAC ID | 4284812827 |
|---|---|
| Medicare Enrollment ID | O20110629000573 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487949889 | NPI | - | NPPES |
| 201030150A | Medicaid | IN |
| Provider Name | Gaurav Kumar |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1225219462 PECOS PAC ID: 9638365653 Enrollment ID: I20110629000618 |
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