Provider Demographics
NPI:1326018094
Name:LEMAY, ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:LEMAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 E COOLSPRING AVE
Mailing Address - Street 2:
Mailing Address - City:MICHIGAN CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46360-6312
Mailing Address - Country:US
Mailing Address - Phone:219-878-5029
Mailing Address - Fax:219-878-8493
Practice Address - Street 1:1225 E COOLSPRING AVE
Practice Address - Street 2:
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-6312
Practice Address - Country:US
Practice Address - Phone:219-878-5029
Practice Address - Fax:219-878-8493
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01031744A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000347054OtherANTHEM
P00246906OtherRR MEDICARE
IN100139330Medicaid
IN217230PMedicare PIN
IN100139330Medicaid
P00246906OtherRR MEDICARE