Provider Demographics
NPI:1952429979
Name:ANESTHESIOLOGISTS OF THE WABASH VALLEY
Entity Type:Organization
Organization Name:ANESTHESIOLOGISTS OF THE WABASH VALLEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:DELILAH
Authorized Official - Middle Name:P
Authorized Official - Last Name:TAPIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-232-2032
Mailing Address - Street 1:3903 S 7TH ST
Mailing Address - Street 2:SUITE 1F
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47834
Mailing Address - Country:US
Mailing Address - Phone:812-232-2032
Mailing Address - Fax:812-232-8252
Practice Address - Street 1:3903 S 7TH ST
Practice Address - Street 2:SUITE 1F
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47834
Practice Address - Country:US
Practice Address - Phone:812-232-2032
Practice Address - Fax:812-232-8252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN132600Medicare PIN