MEDICARE: DR. OLUSEGUN APATA M.D.

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	207RP1001X	Pulmonary Disease Physician	01064140	IN
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	01064140	IN
3	207RS0012X	Sleep Medicine (Internal Medicine) Physician	01604140	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

General Provider Information

NPI Number	:	1043298961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OLUSEGUN APATA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 10068
Second Line	:
City	:	MERRILLVILLE
State	:	IN
Zip	:	46411-0068
Country	:	US
Telephone Number	:	219-882-9900
Fax Number	:

Provider Business Practice Location Address
First Line	:	650 GRANT ST STE 7
Second Line	:
City	:	GARY
State	:	IN
Zip	:	46404-1551
Country	:	US
Telephone Number	:	219-882-9900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	10/31/2013

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