| Puchalapalli M D, Inc. | |
|
2250 Wabash Ave Terre Haute IN 47807-3317 | |
| (812) 232-3225 | |
| (812) 232-4215 |
| Full Name | Puchalapalli M D, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 2250 Wabash Ave, Terre Haute, Indiana |
| Authorized Official Name and Position | Subbareddy Puchalapalli (OWNER) |
| Authorized Official Contact | 8122323225 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Puchalapalli M D, Inc. 2250 Wabash Ave Terre Haute IN 47807-3317 Ph: (812) 232-3225 | Puchalapalli M D, Inc. 2250 Wabash Ave Terre Haute IN 47807-3317 Ph: (812) 232-3225 |
| NPI Number | 1346554169 |
|---|---|
| Provider Enumeration Date | 08/04/2010 |
| Last Update Date | 02/09/2011 |
| Medicare PECOS PAC ID | 6800077447 |
|---|---|
| Medicare Enrollment ID | O20110302000149 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346554169 | NPI | - | NPPES |
| 200148980C | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 01046393A (Indiana) | Primary |
| Provider Name | Subbareddy Puchalapalli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184622078 PECOS PAC ID: 2961486626 Enrollment ID: I20040618000039 |
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