Organization
LAKE MI MOBILE DOCTORS, P.C.
Active
Other names
Mobile Doctors of Indianapolis
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TYSYN CONTRERAS (DIRECTOR, QUALITY ASSURANCE)
(773) 751-7200
Entity
Organization
Contact information
Practice address
3388 FOUNDERS RD, SUITE C, INDIANAPOLIS, IN 46268-1443
(317) 471-8701
(317) 471-8702
Mailing address
3319 N ELSTON AVE, SUITE 200, CHICAGO, IL 60618-5811
(773) 751-7200
(773) 583-4401
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
213E00000X
Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200946960B
—
IN
Enumeration date
05/12/2008
Last updated
04/23/2013
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