| Dr Edwin Boediono Liem, MD | |
|
4023 Reas Ln, New Albany, IN 47150-2228 | |
| (812) 206-7660 | |
| Not Available |
| Full Name | Dr Edwin Boediono Liem |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology |
| Experience | 31 Years |
| Location | 4023 Reas Ln, New Albany, Indiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952354623 | NPI | - | NPPES |
| 64041981 | Medicaid | KY | |
| 000000640496 | Other | IN | ANTHEM |
| 200366540 | Medicaid | IN | |
| P00819295 | Other | IN | RAILROAD MEDICARE |
| 50027044 | Other | IN | PASSPORT ADVANTAGE |
| 50027044 | Other | IN | PASSPORT |
| 111870 | Other | IN | SIHO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | 36354 (Kentucky) | Secondary |
| 207L00000X | Anesthesiology | ME170722 (Florida) | Secondary |
| 207L00000X | Anesthesiology | 01066649A (Indiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Physicians' Medical Center Llc | New albany, IN | Hospital |
| Baptist Health Floyd | New albany, IN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Associated Anesthesiologists Of Fort Wayne Pc | 2264412444 | 89 |
| Sheridan Healthcorp Inc | 3173429693 | 849 |
| Entity Name | Associated Anesthesiologists Of Fort Wayne Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1538159140 PECOS PAC ID: 2264412444 Enrollment ID: O20040720001562 |
| Entity Name | Indiana University Health Care Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902032832 PECOS PAC ID: 5799755864 Enrollment ID: O20040727000955 |
| Entity Name | Northstar Anesthesia Of Indiana Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043561541 PECOS PAC ID: 1153576905 Enrollment ID: O20130227000297 |
| Entity Name | One Anesthesia Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174513246 PECOS PAC ID: 7113816174 Enrollment ID: O20140204000105 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Edwin Boediono Liem, MD 250 N Shadeland Ave, Indianapolis, IN 46219-4959 Ph: () - | Dr Edwin Boediono Liem, MD 4023 Reas Ln, New Albany, IN 47150-2228 Ph: (812) 206-7660 |
Mr. Shantharam H Shetty, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1850 State St, New Albany, IN 47150 Phone: 502-625-5584 Fax: 502-426-2264 | |
Dr. Martin Brieschke, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1850 State St, New Albany, IN 47150 Phone: 502-625-5584 Fax: 502-426-2264 | |
Dr. Barry H Miller, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1850 State St, New Albany, IN 47150 Phone: 502-625-5584 Fax: 502-426-2264 | |
Bridgit Melidones, CRNA Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1850 State St, New Albany, IN 47150 Phone: 812-944-7701 | |
Arthur G. Duncan, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1850 State St, New Albany, IN 47150 Phone: 502-625-5584 Fax: 502-426-2264 | |
Andy Lee, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1850 State St, New Albany, IN 47150 Phone: 502-625-5584 | |
Dr. Keun Yung Yu, M.D. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1850 State St, New Albany, IN 47150 Phone: 502-625-5584 Fax: 502-426-2264 |