| Northwest Indiana Id Associates Pc | |
|
9696 Gordon Dr Highland IN 46322-2909 | |
| (219) 937-2511 | |
| (219) 937-2522 |
| Full Name | Northwest Indiana Id Associates Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 9696 Gordon Dr, Highland, Indiana |
| Authorized Official Name and Position | Kinan Attassi (OWNER) |
| Authorized Official Contact | 6309233555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Indiana Id Associates Pc 9696 Gordon Dr Highland IN 46322-2909 Ph: (219) 937-2511 | Northwest Indiana Id Associates Pc 9696 Gordon Dr Highland IN 46322-2909 Ph: (219) 937-2511 |
| NPI Number | 1659742385 |
|---|---|
| Provider Enumeration Date | 10/07/2015 |
| Last Update Date | 10/07/2015 |
| Medicare PECOS PAC ID | 6608185988 |
|---|---|
| Medicare Enrollment ID | O20151028000759 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659742385 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | 01062044 (Indiana) | Primary |
| Provider Name | Kinan Attassi |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1255428157 PECOS PAC ID: 1850393307 Enrollment ID: I20070213000092 |
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