Organization
PUCHALAPALLI M D, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUBBAREDDY PUCHALAPALLI MD (OWNER)
(812) 232-3225
Entity
Organization
Contact information
Practice address
2250 WABASH AVE, TERRE HAUTE, IN 47807-3317
(812) 232-3225
(812) 232-4215
Mailing address
2250 WABASH AVE, TERRE HAUTE, IN 47807-3317
(812) 232-3225
(812) 232-4215
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01046393A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200148980C
—
IN
Enumeration date
08/04/2010
Last updated
02/09/2011
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