Organization
FOUR SEASONS MEDICAL CENTER, P.C.
Active
Other names
Family Health and Wellness Centre, Ltd
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN STEWART BROWN III M.D. (PRESIDENT)
(219) 736-1022
Entity
Organization
Contact information
Practice address
8683 CONNECTICUT ST, SUITE B, MERRILLVILLE, IN 46410-6388
(219) 736-1022
(219) 769-7554
Mailing address
8683 CONNECTICUT ST, SUITE B, MERRILLVILLE, IN 46410-6388
(219) 736-1022
(219) 769-7554
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
01026202C
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000084541
ANTHEM BCBS
IN
01
—
91107784
BCBS-ILLINOIS
IL
Enumeration date
01/17/2007
Last updated
06/23/2017
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