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Organization

MARCOTTE MEDICAL GROUP, PC

Active
Other names
Marcotte Medical Group, SC, Marcotte Medical Group INC
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TREVOR M MARCOTTE DO (OWNER)
(219) 365-6333
Entity
Organization

Contact information

Practice address
15900 W 101ST AVE, DYER, IN 46311
(219) 365-6333
(219) 365-8291
Mailing address
15900 W 101ST AVE, DYER, IN 46311
(219) 365-6333
(219) 365-8291

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000363441
ANTHEM
IN
05
200424880A
IN
01
5913390001
DMERC
IN
01
9932077
BCBS
IL
Enumeration date
05/17/2006
Last updated
11/21/2023
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