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NPI Code Detail

MEDICARE: P.R. UNNI PC

MEDICARE: P.R. UNNI PC
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
1208800000XUrology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11407989932OTHERINNPI INDIVIDUAL
21427039205OTHERINNPI INDIVIDUAL
31063493542OTHERINNPI INDIVIDUAL

General Provider Information

NPI Number : 1417018094
Entity Type Code : Organization
Provider Name (Legal Business Name) : P.R. UNNI PC
Provider Business Mailing Address
First Line : 371 E 84TH DR
Second Line :
City : MERRILLVILLE
State : IN
Zip : 46410-6484
Country : US
Telephone Number : 219-769-8641
Fax Number : 219-769-2280
Provider Business Practice Location Address
First Line : 371 E 84TH DR
Second Line :
City : MERRILLVILLE
State : IN
Zip : 46410-6484
Country : US
Telephone Number : 219-769-8641
Fax Number : 219-769-2280
Authorized Official
Title or Position : PRESIDENT
Name : DR. P R UNNI
Credential : M.D.
Telephone Number : 219-769-8641
Provider Enumeration Date : 12/13/2006
Last Update Date : 10/29/2007

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