| Premise Health Of Indiana Medical, P.c. | |
|
100 Wellness Center University Of Notre Dame Notre Dame IN 46556-3600 | |
| (574) 634-9355 | |
| (574) 631-3377 |
| Full Name | Premise Health Of Indiana Medical, P.c. |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 100 Wellness Center, Notre Dame, Indiana |
| Authorized Official Name and Position | Jon Leizman (PRESIDENT) |
| Authorized Official Contact | 2164799063 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premise Health Of Indiana Medical, P.c. 5500 Maryland Way Ste 120 Brentwood TN 37027-4993 Ph: () - | Premise Health Of Indiana Medical, P.c. 100 Wellness Center University Of Notre Dame Notre Dame IN 46556-3600 Ph: (574) 634-9355 |
| NPI Number | 1801167879 |
|---|---|
| Provider Enumeration Date | 01/23/2012 |
| Last Update Date | 08/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801167879 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
University Of Notre Dame Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 107 Saint Liam Hall, Notre Dame, IN 46556 Phone: 574-631-6574 Fax: 574-631-3874 |