Organization
MIDWEST CHILD AND ADOLESCENT SPECIALTY GROUP, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PABLITO S. DELA CRUZ M.D. (OWNER)
(812) 232-7337
Entity
Organization
Contact information
Practice address
1310 E DAVIS DR, TERRE HAUTE, IN 47802-4034
(812) 232-7337
(812) 232-7338
Mailing address
1310 E DAVIS DR, TERRE HAUTE, IN 47802-4034
(812) 232-7337
(812) 232-7338
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01059798A
IN
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
01059798A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200506860A
—
IN
Enumeration date
06/10/2006
Last updated
12/20/2011
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