Modi, Sanjiv S

Modi, Sanjiv S is an individual health care provider with primary practice located at 8955 W 400 N , Michigan City IN 46360-9330. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Modi, Sanjiv S can be contacted via phone (219) 861-5800.

Contact Information

Primary practice address
8955 W 400 N Michigan City IN 46360-9330
Phone: (219) 861-5800
Fax: (219) 861-5543
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 036093810 Illinois
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 01093925A Indiana

Profile Details

NPI number 1396730909
LBN Legal business name Modi, Sanjiv S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2005
Last updated Jul 16th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396730909 NPPES
Illinois MEDICAID 036093810
Illinois Other 830007251
Illinois Other L77781
Illinois Other L98056

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