Provider Demographics
NPI:1437223633
Name:GANDHI MEDICAL CENTER, P.C.
Entity Type:Organization
Organization Name:GANDHI MEDICAL CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINUS
Authorized Official - Middle Name:B
Authorized Official - Last Name:GANDHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-838-9333
Mailing Address - Street 1:2727 HIGHWAY AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:46322-1615
Mailing Address - Country:US
Mailing Address - Phone:219-838-9333
Mailing Address - Fax:
Practice Address - Street 1:2727 HIGHWAY AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322-1615
Practice Address - Country:US
Practice Address - Phone:219-838-9333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01036969A207Q00000X
IN01061275A207Q00000X
IN01057594A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DA7388OtherRAILROAD MEDICARE
IN200462460AMedicaid
IN212670Medicare ID - Type Unspecified