Provider Demographics
NPI:1871820324
Name:FIRST MED P.C.
Entity type:Organization
Organization Name:FIRST MED P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ORANU
Authorized Official - Middle Name:
Authorized Official - Last Name:IBEIKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-769-4400
Mailing Address - Street 1:751 E. 81ST PLACE
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410
Mailing Address - Country:US
Mailing Address - Phone:219-769-4400
Mailing Address - Fax:219-795-1419
Practice Address - Street 1:751 E. 81ST PLACE
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410
Practice Address - Country:US
Practice Address - Phone:219-769-4400
Practice Address - Fax:219-795-1419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-04
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71002882A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty