Provider Demographics
NPI:1598737710
Name:BATTLE, INDIA GRACE
Entity Type:Individual
Prefix:
First Name:INDIA
Middle Name:GRACE
Last Name:BATTLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 HAWKINS POINT RD
Mailing Address - Street 2:HEALTH SERVICES DIVISION BLDG 28B
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21226-1797
Mailing Address - Country:US
Mailing Address - Phone:410-636-7506
Mailing Address - Fax:410-636-7868
Practice Address - Street 1:2401 HAWKINS POINT RD
Practice Address - Street 2:HEALTH SERVICES DIVISION BLDG 28B
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21226-1797
Practice Address - Country:US
Practice Address - Phone:410-636-7506
Practice Address - Fax:410-636-7868
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider