MEDICARE: INTERNISTS, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	50000554A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000101276	OTHER	IN	BCBS

General Provider Information

NPI Number	:	1487851945
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERNISTS, INC.

Provider Business Mailing Address
First Line	:	1200 CHESTER BLVD
Second Line	:
City	:	RICHMOND
State	:	IN
Zip	:	47374-1905
Country	:	US
Telephone Number	:	765-966-7724
Fax Number	:	765-966-7725

Provider Business Practice Location Address
First Line	:	1200 CHESTER BLVD
Second Line	:
City	:	RICHMOND
State	:	IN
Zip	:	47374-1905
Country	:	US
Telephone Number	:	765-966-7724
Fax Number	:	765-966-7725

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MS. LIBBY STEELE
Credential	:
Telephone Number	:	765-966-7724

Provider Enumeration Date	:	06/28/2007
Last Update Date	:	11/17/2016

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Directions to “INTERNISTS, INC. ” Practice Location

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