MEDICARE: DOCTORS AT YOUR DOOR SC

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	01043017A	IN

General Provider Information

NPI Number	:	1962889550
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOCTORS AT YOUR DOOR SC

Provider Business Mailing Address
First Line	:	2010 E COLUMBUS DR
Second Line	:
City	:	EAST CHICAGO
State	:	IN
Zip	:	46312-2830
Country	:	US
Telephone Number	:	219-397-1951
Fax Number	:	888-668-6550

Provider Business Practice Location Address
First Line	:	2010 E COLUMBUS DR
Second Line	:
City	:	EAST CHICAGO
State	:	IN
Zip	:	46312-2830
Country	:	US
Telephone Number	:	219-397-1951
Fax Number	:	888-668-6550

Authorized Official
Title or Position	:	M.D.
Name	:	DR. GEOFFREY ONYEUKWU
Credential	:	M.D.
Telephone Number	:	219-884-3447

Provider Enumeration Date	:	05/03/2015
Last Update Date	:	05/03/2015

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Directions to “DOCTORS AT YOUR DOOR SC ” Practice Location

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