MEDICARE: PROFESSIONAL ASSOCIATES PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	207K00000X	Allergy & Immunology Physician
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	IN
3	207RP1001X	Pulmonary Disease Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C10473	OTHER	IN	RAIL ROAD MEDICARE GROUP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316970585
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROFESSIONAL ASSOCIATES PC

Provider Business Mailing Address
First Line	:	3266 N MERIDIAN ST
Second Line	:	SUITE 900
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46208-5846
Country	:	US
Telephone Number	:	317-924-8297
Fax Number	:	317-924-8270

Provider Business Practice Location Address
First Line	:	3266 N MERIDIAN ST
Second Line	:	SUITE 900
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46208-5846
Country	:	US
Telephone Number	:	317-924-8297
Fax Number	:	317-924-8348

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	REBECCA A GOLDBERG
Credential	:
Telephone Number	:	317-924-8297

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	08/25/2010

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Directions to “PROFESSIONAL ASSOCIATES PC ” Practice Location

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