Provider Demographics
NPI:1720107329
Name:PULMONARY MEDICAL ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:PULMONARY MEDICAL ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:S
Authorized Official - Last Name:HARDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-621-2740
Mailing Address - Street 1:1400 N RITTER AVE
Mailing Address - Street 2:SUITE 375
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-3052
Mailing Address - Country:US
Mailing Address - Phone:317-621-2740
Mailing Address - Fax:317-621-5658
Practice Address - Street 1:7250 CLEARVISTA DR
Practice Address - Street 2:STE 120
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-4692
Practice Address - Country:US
Practice Address - Phone:317-621-2740
Practice Address - Fax:317-621-5658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN675230Medicare ID - Type UnspecifiedGROUP MEDICARE ID