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NPI Code Detail

MEDICARE: PHYSICIAN MOBILE MEDICAL CARE PC

MEDICARE: PHYSICIAN MOBILE MEDICAL CARE PC
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
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1518765502
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHYSICIAN MOBILE MEDICAL CARE PC
Provider Business Mailing Address
First Line : 5750 JOHNSTON ST STE 205
Second Line :
City : LAFAYETTE
State : LA
Zip : 70503-5345
Country : US
Telephone Number : 337-408-0797
Fax Number :
Provider Business Practice Location Address
First Line : 40 LA RIVIERE DR STE 500
Second Line :
City : BUFFALO
State : NY
Zip : 14202-4344
Country : US
Telephone Number : 337-408-0797
Fax Number : 716-893-1002
Authorized Official
Title or Position : SVP OF ADMIN SERVICES
Name : NICOLE HOWARD
Credential :
Telephone Number : 337-408-0797
Provider Enumeration Date : 03/05/2025
Last Update Date : 03/03/2026

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Directions to “PHYSICIAN MOBILE MEDICAL CARE PC ” Practice Location

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