Provider Demographics
NPI:1609931716
Name:GREENWOOD PEDIATRICS & INTERNAL MEDICINE, PC
Entity Type:Organization
Organization Name:GREENWOOD PEDIATRICS & INTERNAL MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:A
Authorized Official - Last Name:MAJID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-881-8700
Mailing Address - Street 1:3089 W FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-8504
Mailing Address - Country:US
Mailing Address - Phone:317-881-8700
Mailing Address - Fax:317-881-9200
Practice Address - Street 1:3089 W FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-8504
Practice Address - Country:US
Practice Address - Phone:317-881-8700
Practice Address - Fax:317-881-9200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000104609OtherBCBS
IN200294400AMedicaid
IN000000104609OtherBCBS