Doris Fandohan (NPI# 1679038186, PAC ID# 1557603974) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1679038186 |
| PAC ID by PECOS | 1557603974 |
| Professional Enrollment ID | I20190503000868 |
| Full Name | Doris Fandohan |
| Organization Legal Name | EDGEWATER SYSTEMS FOR BALANCED LIVING INC. |
| Address |
3535 Broadway Gary IN 46409-1316 |
| Phone Number | 2198854264 |
| Gender | F |
| Graduation Year | 2018 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 9234398397 |
| Number of Group Practice Members | 9 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 150002 | METHODIST HOSPITALS INC |
| Address | Phone | Organization |
|---|---|---|
| 3535 Broadway, Gary, IN 46409-1316 | 2198854264 | EDGEWATER SYSTEMS FOR BALANCED LIVING INC. |
| Organization Legal Name | EDGEWATER SYSTEMS FOR BALANCED LIVING INC. |
| Physicians | 6 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Pamela V Tran | Psychiatry | Edgewater Systems for Balanced Living Inc. | 1100 W 6th Ave, Edgewater Beh Hlth Services, Gary, IN 46402-1711 |
| Okechi Nwadozi Nwabara | Internal Medicine | Edgewater Systems for Balanced Living Inc. | 1100 W 6th Ave, Edgewater Beh Hlth Services, Gary, IN 46402-1711 |
| Bianca Chatman | Nurse Practitioner | Edgewater Systems for Balanced Living Inc. | 3535 Broadway, Gary, IN 46409-1316 |
| Mathew V Castelino | Psychiatry | Edgewater Systems for Balanced Living Inc. | 1100 W 6th Ave, Edgewater Beh Hlth Services, Gary, IN 46402-1711 |
| Edith A Jenkins | Nurse Practitioner | Edgewater Systems for Balanced Living Inc. | 1100 W 6th Ave, Edgewater Beh Hlth Services, Gary, IN 46402-1711 |
| Street Address |
3535 BROADWAY |
| City | GARY |
| State | IN |
| Zip | 46409-1316 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bianca Chatman | Nurse Practitioner | Edgewater Systems for Balanced Living Inc. | 3535 Broadway, Gary, IN 46409-1316 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Terasheika Elmore | Nurse Practitioner | The Methodist Hospitals Inc | 3195 Broadway, Gary, IN 46409-1000 |
| James A Tyndall | Physical Therapy | Accelerated Rehabilitation Centers Ltd | 3229 Broadway, Gary, IN 46409-1036 |
| Nathan Lennert | Physical Therapy | Accelerated Rehabilitation Centers Ltd | 3229 Broadway, Gary, IN 46409-1036 |
| Jeremy D Houser | Physical Therapy | Accelerated Rehabilitation Centers Ltd | 3229 Broadway, Gary, IN 46409-1036 |
| Karlene M Cantrell-oram | Physical Therapy | Accelerated Rehabilitation Centers Ltd | 3229 Broadway, Gary, IN 46409-1036 |
| Jay Timothy Ames | Family Medicine | Porter-starke Services Inc | 3229 Broadway, Suite 160, Gary, IN 46409-1036 |
| Amber Lewis | Physical Therapy | Accelerated Rehabilitation Centers Ltd | 3229 Broadway, Gary, IN 46409-1036 |
| Luwanga U Okoro | Cardiovascular Disease (cardiology) | 3229 Broadway, Gary, IN 46409-1036 | |
| Julie C Jerrell | Physical Therapy | Accelerated Rehabilitation Centers Ltd | 3229 Broadway, Gary, IN 46409-1036 |
| Patty A Meding | Nurse Practitioner | The Methodist Hospitals Inc | 3229 Broadway, Gary, IN 46409-1036 |
| Find all physicians in zip 46409 | |||
| City | GARY |
| Zip Code | 46409 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | GARY + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Doris Fandohan.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.