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Contact Information

PODIATRIC MEDICAL ASSOCIATES PC
303 W 89TH AVE
SUITE E-1
MERRILLVILLE, IN46410
 Phone: 219-736-8915
 Fax: 219-736-8928
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for PODIATRIC MEDICAL ASSOCIATES PC

NPI Number 1134237639
LBN Legal business name PODIATRIC MEDICAL ASSOCIATES PC
Authorized official STEPHEN GRANDFIELD - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 08/26/2006
Last updated 12/05/2013 - About 13 years ago
Identifiers
IN License # 07000353A
IN License # 07000785A
IN License # 07000922A
IN Medicaid 100148090
IN Medicaid 100207960
IN Medicaid 200326020
Other 1089370001 MEDICARE DMERC
Other 480016271 RR MEDICARE
Other 480020342 RR MEDICARE
Other 480032400 RR MEDICARE
IN Other 000000084756 ANTHEM
IN Other 000000084758 ANTHEM
IN Other 00000209276 ANTHEM
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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