Organization
MEDICAL ASSOCIATES OF TERRE HAUTE, LLC
Active
Other names
Sullivan Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
AJAY DESHPANDE MD (MANAGING PARTNER)
(812) 605-0543
Entity
Organization
Contact information
Practice address
4320 S 7TH ST, TERRE HAUTE, IN 47802-4301
(812) 905-0912
(812) 905-0913
Mailing address
4320 S 7TH ST, TERRE HAUTE, IN 47802-4301
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RP1001X
Pulmonary Disease Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
01/16/2020
Last updated
01/16/2020
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