Organization
MEDICAL ASSOCIATES OF TERRE HAUTE, LLC
Active
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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