Organization
INTERVENTIONAL CLINICS OF AMERICA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIVEK KUMAR AGRAWAL MD (MEDICAL DIRECTOR)
(408) 460-4502
Entity
Organization
Contact information
Practice address
8300 BROADWAY, SUITE A1, MERRILLVILLE, IN 46410-8602
(219) 779-8346
(925) 380-3168
Mailing address
8300 BROADWAY, SUITE A1, MERRILLVILLE, IN 46410-8602
(219) 779-8346
(925) 380-3168
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
04/24/2012
Last updated
08/30/2012
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