Provider Demographics
NPI:1285671214
Name:COMMUNITY HOSPITALS OF INDIANA, INC
Entity Type:Organization
Organization Name:COMMUNITY HOSPITALS OF INDIANA, INC
Other - Org Name:WAIL BAKDASH, M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:FISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-355-4887
Mailing Address - Street 1:1210 MEDICAL ARTS BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46011-3461
Mailing Address - Country:US
Mailing Address - Phone:765-298-4200
Mailing Address - Fax:765-298-4980
Practice Address - Street 1:1210 MEDICAL ARTS BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46011-3461
Practice Address - Country:US
Practice Address - Phone:765-298-4200
Practice Address - Fax:765-298-4980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
INDB6584OtherRR MEDICARE
INDB6584OtherRR MEDICARE