| Nwi Primary Care LLC | |
|
642 S Lake St Gary IN 46403-2967 | |
| (219) 794-4024 | |
| Not Available |
| Full Name | Nwi Primary Care LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 642 S Lake St, Gary, Indiana |
| Authorized Official Name and Position | Paula Jean Rousis (CEO/PRESIDENT) |
| Authorized Official Contact | 2197944024 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nwi Primary Care LLC 642 S Lake St Gary IN 46403-2967 | Nwi Primary Care LLC 642 S Lake St Gary IN 46403-2967 Ph: (219) 794-4024 |
| NPI Number | 1689077620 |
|---|---|
| Provider Enumeration Date | 10/05/2014 |
| Last Update Date | 10/05/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689077620 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
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