Provider Demographics
NPI:1598099822
Name:THOMAS J. NEDUMTHOTTATHIL, MD
Entity Type:Organization
Organization Name:THOMAS J. NEDUMTHOTTATHIL, MD
Other - Org Name:SHELBYVILLE INTERNAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:NEDUMTHOTTATHIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-685-8620
Mailing Address - Street 1:2839 HIGHWAY 231 N
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-7447
Mailing Address - Country:US
Mailing Address - Phone:931-685-8620
Mailing Address - Fax:931-685-8621
Practice Address - Street 1:2839 HIGHWAY 231 N
Practice Address - Street 2:SUITE 5
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-7447
Practice Address - Country:US
Practice Address - Phone:931-685-8620
Practice Address - Fax:931-685-8621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-18
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty