Organization
UNITY HEALTHCARE, LLC
Active
Other names
Premier Gastroenterology
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA K MILLER (DIRECTOR OF BILLING)
(765) 446-5286
Entity
Organization
Contact information
Practice address
3930 MEZZANINE DR, SUITE D, LAFAYETTE, IN 47905-8646
(765) 807-2787
(765) 807-7989
Mailing address
PO BOX 4699, LAFAYETTE, IN 47903-4699
(765) 449-2732
(765) 449-1196
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201152580 A
—
IN
Enumeration date
03/13/2013
Last updated
07/17/2013
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