My Mobile MD Northern Indiana
Family Medicine in Indianapolis, IN. Organization (NPI-2).
NPI number1629623913
StatusActive
Last updated in NPPESApr 21, 2020
Details
- NPI
- 1629623913
- Entity type
- Organization (NPI-2)
- Legal business name
- My Mobile MD Northern Indiana
- Organization subpart
- No
- Enumeration date
- Aug 5, 2019
- Certification date
- Apr 21, 2020
- Last updated
- Apr 21, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Practice location
429 E Vermont St Ste 110Indianapolis, IN 46202-3685
Phone 317-559-0950 · Fax 317-936-3028
Mailing address
Po Box 305Union City, IN 47390-0305
Phone 765-969-7841
Authorized official
Steve Martin
Ceo
3176706635
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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