MEDICARE: LA PORTE COUNTY ANESTHESIA ASSOCIATES LLC

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	207L00000X	Anesthesiology Physician

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	:	1477553634
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LA PORTE COUNTY ANESTHESIA ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	1507 WABASH ST
Second Line	:	SUITE 400C
City	:	MICHIGAN CITY
State	:	IN
Zip	:	46360-4300
Country	:	US
Telephone Number	:	219-871-0833
Fax Number	:	219-871-0836

Provider Business Practice Location Address
First Line	:	3500 FRANCISCAN WAY
Second Line	:
City	:	MICHIGAN CITY
State	:	IN
Zip	:	46360-0033
Country	:	US
Telephone Number	:	192-877-1033
Fax Number	:	178-856-0655

Authorized Official
Title or Position	:	OWNER
Name	:	JAMIL AHMED
Credential	:	M.D.
Telephone Number	:	219-877-7947

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	07/28/2025

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Directions to “LA PORTE COUNTY ANESTHESIA ASSOCIATES LLC ” Practice Location

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