Individual
MARCIA L FAVALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
221 S 6TH ST, TERRE HAUTE, IN 47807-4214
(812) 242-3120
(812) 242-3846
Mailing address
221 S 6TH ST, TERRE HAUTE, IN 47807-4214
(812) 242-3120
(812) 242-3846
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01033320A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000089614
ANTHEM
—
01
—
080011074
RAILROAD MCARE PALAMETTO
—
05
—
100251840
—
IN
01
—
P00834918
RAILROAD MEDICARE
IN
Enumeration date
08/21/2006
Last updated
08/18/2010
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