| Diamond Medical Group | |
|
830 Park East Blvd Lafayette IN 47905-0778 | |
| (219) 448-0369 | |
| Not Available |
| Full Name | Diamond Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 830 Park East Blvd, Lafayette, Indiana |
| Authorized Official Name and Position | Benerji Gudapati (OWNER) |
| Authorized Official Contact | 2194480369 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diamond Medical Group 3679 Wakefield Dr West Lafayette IN 47906-8708 Ph: (219) 448-0369 | Diamond Medical Group 830 Park East Blvd Lafayette IN 47905-0778 Ph: (219) 448-0369 |
| NPI Number | 1790297935 |
|---|---|
| Provider Enumeration Date | 10/27/2017 |
| Last Update Date | 02/14/2018 |
| Medicare PECOS PAC ID | 5799045688 |
|---|---|
| Medicare Enrollment ID | O20180214002816 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790297935 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
| Provider Name | Benerji Gudapati |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1962459099 PECOS PAC ID: 5092712166 Enrollment ID: I20061102000288 |
Tlc Consulting Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 427 Main St Ste 210, Lafayette, IN 47901 Phone: 765-404-8099 |
Woodhaven Behavioral LLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 100 Executive Dr Ste D, Lafayette, IN 47905 Phone: 765-537-3880 Fax: 765-548-4332 |
Kelly Nutrition, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Executive Dr Ste F, Lafayette, IN 47905 Phone: 765-413-5609 |
St Elizabeth Infusion Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1345 Unity Pl, Suite 365, Lafayette, IN 47905 Phone: 765-446-5417 Fax: 765-446-5317 |
Horizon Oncology Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1345 Unity Pl, Ste 365, Lafayette, IN 47905 Phone: 765-446-5111 Fax: 765-446-5165 |
Valley Oaks Health Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2323 Ferry Street, Floor 2, Lafayette, IN 47904 Phone: 866-682-5539 |