Provider Demographics
NPI:1275645228
Name:TERREHAUTE INTERNAL MEDICINE LLC
Entity Type:Organization
Organization Name:TERREHAUTE INTERNAL MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:PARDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-238-0958
Mailing Address - Street 1:420 E HOSPITAL LN
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-4251
Mailing Address - Country:US
Mailing Address - Phone:812-238-0958
Mailing Address - Fax:812-238-0960
Practice Address - Street 1:420 E HOSPITAL LN
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-4251
Practice Address - Country:US
Practice Address - Phone:812-238-0958
Practice Address - Fax:812-238-0960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty