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NPI Code Detail

MEDICARE: NOVAMED SURGERY CENTER OF MERRILLVILLE, LLC

MEDICARE: NOVAMED SURGERY CENTER OF MERRILLVILLE, 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
1261QA1903XAmbulatory Surgical Clinic/Center05-005727-1IN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1490005624OTHERRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609874254
Entity Type Code : Organization
Provider Name (Legal Business Name) : NOVAMED SURGERY CENTER OF MERRILLVILLE, LLC
Provider Business Mailing Address
First Line : 9797 MASSACHUSETTS ST
Second Line :
City : CROWN POINT
State : IN
Zip : 46307-0278
Country : US
Telephone Number : 219-756-5010
Fax Number : 219-756-5106
Provider Business Practice Location Address
First Line : 9797 MASSACHUSETTS ST
Second Line :
City : CROWN POINT
State : IN
Zip : 46307-0278
Country : US
Telephone Number : 219-756-5010
Fax Number : 219-756-5106
Authorized Official
Title or Position : BILLING MANAGER
Name : MS. SUE GLASS
Credential :
Telephone Number : 219-937-5067
Provider Enumeration Date : 07/08/2005
Last Update Date : 03/06/2025

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Directions to “NOVAMED SURGERY CENTER OF MERRILLVILLE, LLC ” Practice Location

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