Podiatric Medical Associates Pc
LBN: Podiatric Medical Associates Pc
Podiatric Medical Associates Pc is an health care organization with primary practice located at 6289 Central Ave , Portage IN 46368-3725. The organization recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Podiatrist is the primary health care specialty.
Podiatric Medical Associates Pc can be contacted via phone (219) 763-2008, or through Grandfield, Stephen K via phone (219) 763-2008.
Contact Information
Primary practice address
6289 Central Ave
Portage IN 46368-3725
Phone: (219) 763-2008
Fax: (219) 762-2291
Website:
Authorized official contact:
Name: Grandfield, Stephen K Doctor of Podiatric Medicine (DPM)
Phone: (219) 763-2008
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | ||
| Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X |
Profile Details
| NPI number | 1982728200 |
|---|---|
| LBN Legal business name | Podiatric Medical Associates Pc |
| DBA Doing business as | |
| Authorized official | Grandfield, Stephen K Doctor of Podiatric Medicine (DPM) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 19th, 2007 |
| Last updated | Dec 18th, 2013 - about 11 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982728200 | NPPES |
| Indiana | MEDICAID | 200326020 | |
| Indiana | Other | 492470 | |
| Indiana | MEDICAID | 100907960 |
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