MEDICARE: NEUROLOGY AND PAIN MANAGEMENT ASSOCIATES, P.C.

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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1225089469
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEUROLOGY AND PAIN MANAGEMENT ASSOCIATES, P.C.

Provider Business Mailing Address
First Line	:	PO BOX 10299
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46851-0299
Country	:	US
Telephone Number	:	574-546-1900
Fax Number	:	574-546-1999

Provider Business Practice Location Address
First Line	:	2100 N MAIN ST STE 304
Second Line	:
City	:	CROWN POINT
State	:	IN
Zip	:	46307-1877
Country	:	US
Telephone Number	:	574-546-1900
Fax Number	:	574-546-1999

Authorized Official
Title or Position	:	CEO
Name	:	STEVEN POSAR
Credential	:	MD
Telephone Number	:	574-546-1900

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	02/26/2021

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