Healthcare Provider Details

I. General information

NPI: 1477734366
Provider Name (Legal Business Name): TARANGINI T. PADHYA MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2007
Last Update Date: 02/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 E 86TH CT SUITE D
MERRILLVILLE IN
46410-6259
US

IV. Provider business mailing address

55 E 86TH AVE PO BOX 10645
MERRILLVILLE IN
46410-6382
US

V. Phone/Fax

Practice location:
  • Phone: 219-736-9042
  • Fax: 219-736-9247
Mailing address:
  • Phone: 219-769-1670
  • Fax: 219-738-6714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01055876
License Number StateIN

VIII. Authorized Official

Name: TARANGINI T. PADHYA
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 219-736-9042