Provider Demographics
NPI:1417087065
Name:MEDICAL HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:MEDICAL HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SIRAJ
Authorized Official - Middle Name:K
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-878-5864
Mailing Address - Street 1:10176 W 400 N
Mailing Address - Street 2:SUITE B
Mailing Address - City:MICHIGAN CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46360-9008
Mailing Address - Country:US
Mailing Address - Phone:219-878-5864
Mailing Address - Fax:219-878-0632
Practice Address - Street 1:10176 W 400 N
Practice Address - Street 2:SUITE B
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-9008
Practice Address - Country:US
Practice Address - Phone:219-878-5864
Practice Address - Fax:219-878-0632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207R00000X, 207RC0200X
IN207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000174342OtherANTHEM
IN160170Medicare ID - Type Unspecified