Individual
JUAN J CORREA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1711 N 6 1/2 ST, STE 200, TERRE HAUTE, IN 47804-2766
(812) 242-3610
(812) 242-3630
Mailing address
221 S 6TH ST, TERRE HAUTE, IN 47807-4214
(812) 242-3610
(812) 242-3630
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
01027664A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000089646
ANTHEM
—
05
—
100250360
—
IN
01
—
P00818705
RAILROAD MEDICARE
IN
Enumeration date
08/23/2006
Last updated
08/18/2010
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