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NORTH CENTRAL INDIANA MEDICAL CLINIC LLC NPI 1730713017


NPI Information

NPI: 1730713017
Provider Name: NORTH CENTRAL INDIANA MEDICAL CLINIC LLC
Classification: Obstetrics & Gynecology - 207VG0400X
Entity Type: Organization

Specialization: Gynecology

CLIA Number: 15D2180277

Address:
112 S MAIN ST
MILFORD, IN
ZIP 46542
Phone: (574) 832-6246
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NORTH CENTRAL INDIANA MEDICAL CLINIC LLC is a gynecology obstetrics gynecology in Milford, IN. The provider is a physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee NORTH CENTRAL INDIANA MEDICAL CLINIC LLC NPI is 1730713017. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

112 S MAIN ST
MILFORD, IN
ZIP 46542-006
Phone: (574) 832-6246

The provider's authorized official is Michelle Wilson .
The authorized official title is Practice Manager and has the following contact phone number (574) 832-6246.

The CLIA number assigned to this NPI record is 15D2180277 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/26/2020 and was last updated on 8/6/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207VG0400XObstetrics & GynecologyGynecologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11902-89-0718OTHERINDIANAOB/GYN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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