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NPI Code Detail

MEDICARE: INDERPAL S THETHI M. D.

MEDICARE:   INDERPAL S THETHI  M. D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0200XCritical Care Medicine (Internal Medicine) Physician35.094974OH
2207RC0200XCritical Care Medicine (Internal Medicine) Physician57614TN
3207RP1001XPulmonary Disease Physician57614TN
4207RP1001XPulmonary Disease Physician35.094974OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
135.094974OTHEROHOH MEDICAL LICENSE

General Provider Information

NPI Number : 1477756757
Entity Type Code : Individual
Provider Name (Legal Business Name) : INDERPAL S THETHI M. D.
Provider Business Mailing Address
First Line : 1001 BELLEFONTAINE AVE
Second Line :
City : LIMA
State : OH
Zip : 45804-2800
Country : US
Telephone Number : 419-998-4575
Fax Number : 419-998-4514
Provider Business Practice Location Address
First Line : 1003 BELLEFONTAINE AVE STE 150
Second Line :
City : LIMA
State : OH
Zip : 45804-1871
Country : US
Telephone Number : 419-998-8295
Fax Number : 419-226-8323
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2007
Last Update Date : 04/30/2021

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Directions to “ INDERPAL S THETHI M. D.” Practice Location

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