Organization
PAIN MANAGEMENT CENTER OF SOUTHERN INDIANA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAMAL K. TIWARI (OWNER)
(812) 232-7246
Entity
Organization
Contact information
Practice address
3654 S 4TH ST, TERRE HAUTE, IN 47802-5543
(812) 232-7246
(812) 232-7202
Mailing address
4330 S ROCKPORT RD, BLOOMINGTON, IN 47403-9765
(812) 232-7246
(812) 232-7202
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
IN
208VP0000X
Pain Medicine Physician
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100389270
—
IN
Enumeration date
04/20/2009
Last updated
06/15/2009
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