Provider Demographics
NPI:1497456677
Name:HEYDAY HEALTH MEDICAL GROUP INDIANA PC
Entity Type:Organization
Organization Name:HEYDAY HEALTH MEDICAL GROUP INDIANA PC
Other - Org Name:HEYDAY HEALTH MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NUPUR
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-277-0099
Mailing Address - Street 1:333 N ALABAMA ST STE 350
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-2275
Mailing Address - Country:US
Mailing Address - Phone:833-343-9329
Mailing Address - Fax:
Practice Address - Street 1:333 N ALABAMA ST STE 350
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-2275
Practice Address - Country:US
Practice Address - Phone:833-343-9329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-14
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty