Organization
EMMANUEL B FAVILA, M.D.P.C.
Active
Organization
EMMANUEL B FAVILA, M.D.P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMMANUEL B FAVILA MD (OWNER)
(812) 238-2100
Entity
Organization
Contact information
Practice address
97 E HALT DR, TERRE HAUTE, IN 47802-4285
(812) 238-2100
(812) 232-7772
Mailing address
97 E HALT DR, TERRE HAUTE, IN 47802-4285
(812) 238-2100
(812) 232-7772
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01039992A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000092869
BLUE CROSS/BLUE SHIELD
IN
05
—
100326580
—
IN
Enumeration date
12/29/2008
Last updated
05/13/2010
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