Provider Demographics
NPI:1407871080
Name:COMMUNITY HOSPITALS OF INDIANA
Entity Type:Organization
Organization Name:COMMUNITY HOSPITALS OF INDIANA
Other - Org Name:DANIELA DJODJEVA, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:FISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-355-4887
Mailing Address - Street 1:1827 N MADISON AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46011-2166
Mailing Address - Country:US
Mailing Address - Phone:765-298-4511
Mailing Address - Fax:
Practice Address - Street 1:1827 N MADISON AVE
Practice Address - Street 2:SUITE A
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46011-2166
Practice Address - Country:US
Practice Address - Phone:765-298-4511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN218900Medicare PIN