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NPI Code Detail

MEDICARE: DR. TERRI A PELLOW MD

MEDICARE: DR. TERRI A PELLOW MD
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
12084P0800XPsychiatry Physician01030207AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518918671
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TERRI A PELLOW MD
Provider Business Mailing Address
First Line : 8320 MADISON AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46227-6066
Country : US
Telephone Number : 317-882-5122
Fax Number : 317-888-8642
Provider Business Practice Location Address
First Line : 8320 MADISON AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46227-6066
Country : US
Telephone Number : 317-882-5122
Fax Number : 317-888-8642
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2006
Last Update Date : 05/02/2012

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Directions to “ DR. TERRI A PELLOW MD” Practice Location

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