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General NPI Number Information
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NPI Number | 1326146952
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Entity Type | Organization
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Legal Business Name | G & V MEDICAL SERVICES
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 8149 KENNEDY AVE SUITE A
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City | HIGHLAND
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State | IN
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Zip | 46322-1128
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Country | US
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Telephone | 219-923-8540
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Fax | 219-923-6742
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Provider Business Mailing Address
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Address Line | PO BOX 1154
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City | CROWN POINT
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State | IN
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Zip | 46308-1154
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Country | US
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Telephone | 219-923-8540
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Fax | 219-923-6742
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Authorized Official
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Title or Position | OWNER
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Name | GOPAL SHAH
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Credential |
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Telephone | 219-923-8540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 01042125A
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License Number State | IN
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