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General NPI Number Information
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NPI Number | 1275645228
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Entity Type | Organization
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Legal Business Name | TERREHAUTE INTERNAL MEDICINE LLC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 08/22/2014
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Provider Practice Location Address
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Address Line | 420 E HOSPITAL LN
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City | TERRE HAUTE
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State | IN
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Zip | 47802-4251
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Country | US
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Telephone | 812-238-0958
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Fax | 812-238-0960
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Provider Business Mailing Address
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Address Line | 420 E HOSPITAL LN
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City | TERRE HAUTE
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State | IN
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Zip | 47802-4251
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Country | US
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Telephone | 812-238-0958
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Fax | 812-238-0960
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. PARDEEP KUMAR
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Credential | MD
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Telephone | 812-238-0958
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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