Individual
DR. WANDA JEANNE MICHAELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
620 8TH AVE, TERRE HAUTE, IN 47804-2744
(812) 231-8200
Mailing address
PO BOX 4323, TERRE HAUTE, IN 47804-0323
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
J4922
TX
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
J4922
TX
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
J4922
TX
2084F0202X
Forensic Psychiatry Physician
J4922
TX
2084P0800X
Psychiatry Physician
Primary
01079593A
IN
2084P0800X
Psychiatry Physician
J4922
TX
2084P0805X
Geriatric Psychiatry Physician
J4922
TX
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
J4922
TX
2084S0010X
Sports Medicine (Psychiatry & Neurology) Physician
J4922
TX
208D00000X
General Practice Physician
J4922
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1135162
—
TX
Enumeration date
06/27/2006
Last updated
03/17/2018
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