Provider Demographics
NPI:1497808968
Name:PATIENTS FIRST EMERGENCY MEDICINE CONSULTANTS PC
Entity Type:Organization
Organization Name:PATIENTS FIRST EMERGENCY MEDICINE CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:MACUGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-836-7049
Mailing Address - Street 1:PO BOX 678691
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-8691
Mailing Address - Country:US
Mailing Address - Phone:972-758-3598
Mailing Address - Fax:972-599-9604
Practice Address - Street 1:15061 W 197TH AVE
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:IN
Practice Address - Zip Code:46356-9456
Practice Address - Country:US
Practice Address - Phone:219-836-7049
Practice Address - Fax:219-836-7048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71002085A163W00000X
207P00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
INCJ9251OtherMEDICARE RAILROAD
IL90001082OtherBCBS
IN=========001OtherTRICARE
IN201420Medicare PIN