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General NPI Number Information
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NPI Number | 1689064297
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Entity Type | Organization
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Legal Business Name | NWI MEDICAL CONSULTANTS
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Dates
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Enumeration Date | 02/03/2015
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Last Update Date | 02/03/2015
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Provider Practice Location Address
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Address Line | 5304 BROADWAY
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City | MERRILLVILLE
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State | IN
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Zip | 46410-1555
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Country | US
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Telephone | 630-699-6846
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Fax |
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Provider Business Mailing Address
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Address Line | 5304 BROADWAY
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City | MERRILLVILLE
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State | IN
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Zip | 46410-1555
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Country | US
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Telephone | 630-699-6846
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | FAIZUDDIN SHAREEF
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Credential | D.O.
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Telephone | 630-699-6846
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 02003711A
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License Number State | IN
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