Organization
AGUSTI MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE L AGUSTI MD (PRESIDENT)
(219) 900-3990
Entity
Organization
Contact information
Practice address
4900 E 107TH CT, WINFIELD, IN 46307-2862
(219) 386-5018
(219) 472-0089
Mailing address
4900 E 107TH CT, WINFIELD, IN 46307-2862
(219) 900-3990
(219) 472-0089
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01061624A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200832510
—
IN
05
—
200967510A
—
IN
01
—
P00778872,DP6718
RAILROAD MEDICARE
IN
Enumeration date
07/02/2009
Last updated
12/27/2023
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