| Michael A Nicholas, DO | |
|
2150 Gettler St Ste 400, Dyer, IN 46311-2385 | |
| (219) 865-0893 | |
| (219) 865-3599 |
| Full Name | Michael A Nicholas |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine - Interventional Cardiology |
| Location | 2150 Gettler St Ste 400, Dyer, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598740748 | NPI | - | NPPES |
| 000000095311 | Other | IN | ANTHEM PIN |
| 060030029 | Other | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RC0000X | Internal Medicine - Cardiovascular Disease | 02000901A (Indiana) | Secondary |
| 207RI0011X | Internal Medicine - Interventional Cardiology | 02000901A (Indiana) | Primary |
| Entity Name | Franciscan Physician Network |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225327984 PECOS PAC ID: 3072790682 Enrollment ID: O20110608000486 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael A Nicholas, DO Po Box 781076, Detroit, MI 48278-1076 Ph: (317) 528-4800 | Michael A Nicholas, DO 2150 Gettler St Ste 400, Dyer, IN 46311-2385 Ph: (219) 865-0893 |
Dr. Sumanth Mulamalla, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 15900 W 101st Ave, Dyer, IN 46311 Phone: 219-365-6333 Fax: 219-365-8291 | |
Jeannie Boram Ur, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 24 Joliet St, Dyer, IN 46311 Phone: 219-852-1524 Fax: 219-933-2288 | |
Eshwar Nagraj Murthy, Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 24 Joliet St, Dyer, IN 46311 Phone: 219-852-1524 Fax: 219-933-2288 | |
Mohamad Kassar, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1001 Calumet Ave, Dyer, IN 46311 Phone: 219-924-8178 Fax: 219-924-8179 | |
C Richard Smith, DO Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 2150 Gettler St Ste 400, Dyer, IN 46311 Phone: 219-865-0893 Fax: 219-865-3599 | |
Dr. Vladimir Selounski, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 24 Joliet St, Dyer, IN 46311 Phone: 219-852-1524 Fax: 219-933-2288 | |
Dr. Harold Leroy Rahming, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 24 Joliet St, Dyer, IN 46311 Phone: 219-852-1524 Fax: 219-933-2288 |