Organization
VITUITY - INDIANA CRITICAL CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEOPHILE KOURY MD (PRESIDENT)
(510) 350-2600
Entity
Organization
Contact information
Practice address
1606 N 7TH ST, TERRE HAUTE, IN 47804-2706
(812) 238-7000
Mailing address
2100 POWELL ST STE 400, EMERYVILLE, CA 94608-1826
(510) 350-2600
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
04/20/2021
Last updated
07/19/2024
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