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General NPI Number Information
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NPI Number | 1972650950
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Entity Type | Organization
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Legal Business Name | MERRILLVILLE CLINIC PC
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 01/04/2012
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Provider Practice Location Address
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Address Line | 7899 TAFT ST
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City | MERRILLVILLE
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State | IN
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Zip | 46410-5284
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Country | US
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Telephone | 219-769-4333
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Fax |
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Provider Business Mailing Address
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Address Line | 7899 TAFT ST
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City | MERRILLVILLE
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State | IN
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Zip | 46410-5284
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Country | US
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Telephone | 219-769-4333
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MS. KELLEY L RAMSEY
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Credential |
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Telephone | 219-331-9615
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 01027935
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License Number State | IN
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