Midwest Medical Associates, LLC
Organization Active NPI Family Medicine Physician · Boonville, IN
NPI 1033215645 · NPPES record last updated Oct 19, 2007
Key facts
- NPI
- 1033215645
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 01047204 (IN)
- Legal business name
- MIDWEST MEDICAL ASSOCIATES, LLC
- Practice address
- 1116 Millis Ave
Suite 101
Boonville, IN 47601-2242 - Phone
- (812) 897-7383
- Fax
- (812) 897-7236
- NPI assigned
- Sep 15, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Maria Rita Bolisay, MD
- Title
- Partner
- Phone
- (812) 897-7383
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 01047204 | IN | Yes |
Addresses
Primary practice location
1116 Millis Ave
Suite 101
Boonville, IN 47601-2242
Mailing address
1116 Millis Ave
Suite 101
Boonville, IN 47601-2242
Phone (812) 897-7383
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200404200A | Medicaid | IN |
Other providers in Boonville, IN
- Major Hospital
- Bhargavi Mandipalle
- Sierra Meier
- Stephen Andrew Meyer
- Michael P Royalty MD LLC
- Josel V Mijares
- James Wirick Miller Jr.
- Lisa M Miller
- Lori Allison Miller
- Kasey Mills
All providers in Boonville, IN · Family Medicine Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 19, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.