| Michael J Nommensen, MD | |
|
1573 N Cline Ave, Griffith, IN 46319-1567 | |
| (219) 838-2311 | |
| Not Available |
| Full Name | Michael J Nommensen |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 1573 N Cline Ave, Griffith, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831105808 | NPI | - | NPPES |
| 000000651853 | Other | IN | ANTHEM |
| 036121930 | Medicaid | IL | |
| 200976940 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036-121930 (Illinois) | Secondary |
| 207Q00000X | Family Medicine | 01066790A (Indiana) | Primary |
| Entity Name | Eskenazi Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730451063 PECOS PAC ID: 4284546813 Enrollment ID: O20031103000440 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael J Nommensen, MD 1040 Sierra Drive, Suite 400, Greenwood, IN 46143-7241 Ph: (317) 528-4886 | Michael J Nommensen, MD 1573 N Cline Ave, Griffith, IN 46319-1567 Ph: (219) 838-2311 |
Charles Mok Jr., DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1573 N Cline Ave, Griffith, IN 46319 Phone: 219-838-2312 Fax: 219-972-7177 | |
Dr. Mohamed Monzer Krad, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 315 W 35th Ave, Griffith, IN 46319 Phone: 219-923-9200 Fax: 219-972-1557 |